Telephonic Nurse Case Manager I

About the role

The Telephonic Nurse Case Manager I role is designed to support members with complex and chronic care needs. Associates can work virtually full-time, with occasional in-person training sessions. This role requires a BA/BS in a health-related field and at least 3 years of clinical experience, or a combination of education and experience providing an equivalent background. A current unrestricted RN license in applicable states is required, along with multi-state licensure if providing services in multiple states.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and develop a care management plan.
• Implement care plan by facilitating authorizations/referrals and coordinating internal and external resources.
• Maintain and modify the care management plan as necessary.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem-solving with providers, claims, or service issues.

Requirements

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

Qualifications

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

Skills

• Certification as a Case Manager preferred.

Benefits

Elevance Health offers a comprehensive benefits package, including incentive and recognition programs, equity stock purchase, and a 401(k) match. Additional benefits include medical, dental, vision, short and long-term disability, and life insurance. The salary range for this specific position is $70,560 to $110,880, with additional details provided in the job description.

Pay

The salary range for this specific position is $70,560 to $110,880. The actual compensation may vary based on geographic location, work experience, education, and skill level.

Schedule

Monday–Friday 8:30am to 5:00pm in your time zone, with 2–4 late shifts per month (11:30 AM–8:00 PM EST).

Who We Are

Elevance Health is a health company dedicated to improving lives and communities. 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

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs. We also provide medical, dental, vision, short and long-term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs, and financial education resources.

Equal Employment Opportunity

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.