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 designed to optimize member health care across the care continuum.
Responsibilities
- 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.
- Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
- Collaborates with internal and external resources to meet identified needs.
- Maintains and evaluates the effectiveness of the care management plan and makes necessary modifications.
- Interacts 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
- Bachelor's degree in a health-related field and minimum of 3 years of clinical experience, or equivalent combination of education and experience.
- Current, unrestricted RN license in applicable state(s).
- Multi-state licensure is required if providing services in multiple states.
Preferred Skills, Capabilities & Experiences
- Certification as a Case Manager is preferred.
Benefits
Commensurate with experience.
Pay
Commensurate with experience.
Schedule
Monday – Friday 9am - 6pm CST.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success – for our consumers, our associates, our communities and our business.
Additional Information
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 elevancehealthjobssupport@elevancehealth.com for assistance.