Telephonic Nurse Case Manager II

Telephonic Nurse Case Manager II at Elevance Health

Base Pay Range: $76,944 - $126,408 per year.

Location:

Work virtually full‑time with occasional in‑person training sessions.

Hours:

Monday – Friday 9:00 am to 5:30 pm EST and one late evening shift 11:30 am to 8:00 pm EST.

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and develop a specific care management plan to address objectives and goals identified during assessment.
• Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra‑contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

• BS/BA in a health‑related field and a minimum of 5 years of clinical experience; or an equivalent combination of education and experience.
• Current, unrestricted RN license in applicable state(s) required.
• Multi‑state licensure required if services are provided in multiple states.

• Case Manager certification.
• Ability to talk and type simultaneously.
• Demonstrated 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 manner.
• Minimum 2 years experience in an acute care setting.
• Minimum 2 years telephonic case management experience with a managed care company.
• Managed care experience.

Mid‑Senior level

Full‑time

Management

Industries:
Business Consulting and Services

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process may contact elevancehealthj for assistance.

In addition to salary, Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, 401(k) contribution, and other benefits subject to eligibility requirements.