Telephonic Nurse Case Manager

Join to apply for the Telephonic Nurse Case Manager I role at Elevance Health

5 days ago Be among the first 25 applicants

$68,880.00/yr – $/yr

• Virtual full‑time, with required in‑person training sessions.

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Work Schedule:

Monday to Friday, 9:00 AM – 5:30 PM EST, with 2‑4 late‑evening shifts per month from 11:30 AM – 8:00 PM EST.

• Multi‑state licensure is required, as the position will service members across different states.

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and create a specific care management plan to address objectives and goals identified during assessment.
• Implements the 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.

• BA/BS in a health‑related field and minimum of 3 atted years of clinical experience; or any combination of education and experience that provides an equivalent background.
• Current unrestricted RN license in applicable state(s) required.
• Multi‑state licensure is required to provide services in multiple states.

• Certification as a Case Manager.

Elevance Health is an Equal Employment Opportunity employer. All qualified applicants will cobrata 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.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and stö California Fair Chance Act.