Nurse Case Manager I 100% Virtual, CareBridge (US)

About the role

The Nurse Case Manager I 100% virtual position at CareBridge Health is responsible for performing care management within the scope of licensure for members with complex and chronic care needs. This role involves conducting assessments, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize member health care across the care continuum. Duties include ensuring member access to appropriate services, facilitating authorizations/referrals, coordinating resources, and interfacing with medical directors and physician advisors.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and develop a specific care management plan.
• Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
• Captures and coordinates internal and external resources to meet identified needs.
• Makes sure the care management plan is effective and modifies it as necessary.
• Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Aids in problem-solving with providers, claims, or service issues.

Requirements

• BA/BS in a health-related field and minimum of 3 years of clinical experience, or any combination of education and experience providing an equivalent background.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if this individual is providing services in multiple states.

Preferred Skills, Capabilities And Experiences

• Certification as a Case Manager is preferred.

Benefits

At CareBridge Health, we offer a comprehensive benefits package that includes:

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs (unless covered by a collective bargaining agreement)
• Medical, dental, and vision insurance
• Short and long-term disability benefits
• 401(k) +match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

Schedule

This role is a 100% virtual position with work hours from Monday to Friday, 9am to 6pm CST.

Pay

Compensation details are confidential and will be provided upon successful completion of the interview process.

Who We Are

CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. We exist to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community-based services.

How We Work

We are committed to creating a culture that advances our strategy while fostering personal and professional growth for our associates. Our values and behaviors form the foundation of our culture, driving our shared success for our consumers, associates, communities, and business.

Elevance Health

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 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 the California Fair Chance Act.