Telephonic Nurse Case Manager, I

🔥 15 minutes ago

🍑 Georgia – Remote

🍑 Georgia – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

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Elevance Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Elevance Health is transforming from a traditional health benefits organization into a lifetime trusted health partner, driven by a bold purpose to improve the health of humanity. With nearly 100,000 associates, they serve over 118 million people and utilize an integrated whole health approach supported by industry-leading capabilities and a digital health platform. Their mission includes redefining health, reimagining the health system, and strengthening communities.

📋 Description

• Provide telephonic care management within the scope of licensure for members with complex and chronic care needs • Assess member needs and develop specific care management plans • Implement care plans by facilitating authorizations and referrals within the benefits structure or through extra-contractual arrangements • Coordinate internal and external resources to meet identified needs • Monitor and evaluate care plan effectiveness and modify plans as necessary • Ensure member access to services appropriate to their health needs • Interface with Medical Directors and Physician Advisors on care management treatment plans • Assist with provider, claims, or service issue problem solving • Assist with developing utilization and care management policies and procedures

🎯 Requirements

• BA/BS in a health-related field • 3 years of clinical experience, or any combination of education and experience providing an equivalent background • Current, unrestricted RN license from the State of Georgia • Multistate licensure required when providing services in multiple states • Ability to talk and type at the same time • Certification as a Case Manager preferred • Critical thinking skills when interacting with members • Experience with Microsoft Office and/or ability to learn new computer programs, systems, and software quickly • Ability to manage, review, and respond to emails/instant messages in a timely fashion • Must reside in the State of Georgia • Must be within a reasonable commuting distance from the posting location unless an accommodation is granted • Completion of an online pre-employment skills assessment within 48 hours of receipt and meeting the assessment criteria

🏖️ Benefits

• Merit increases • Paid holidays • Paid Time Off • Incentive bonus programs • Medical benefits • Dental benefits • Vision benefits • Short-term disability benefits • Long-term disability benefits • 401(k) + match • Stock purchase plan • Life insurance • Wellness programs • Financial education resources • Virtual full-time work arrangement, except for required in-person training sessions

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