Telephonic Nurse Case Manager II

About the role

This role enables associates to work virtually full-time, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
• Affords assistance in facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Maintains oversight and evaluation of the care management plan and modifies as necessary.
• Interfaces with Medical Directors and other Health Professionals on the development of care management treatment plans.
• Affords assistance in problem solving with providers, claims or service issues.
• Affords assistance in the development of utilization/care management policies and procedures.

Requirements

• Requires BS in a health-related field and minimum of 5 years of nursing clinical experience.
• Current, unrestricted RN license is required.
• Multi-state licensure will be required, as individuals will be providing services in multiple states.

Preferred Capabilities, Skills And Experiences

• Experience with the Microsoft Office suite and/or the ability to learn new computer programs/systems/software quickly, preferred.
• Ability to talk and type at the same time, preferred.
• Background in an acute care setting (e.g., hospital/ED/ICU/med-surg), preferred.
• Telephonic and/or virtual nursing experience, preferred.
• Managed Care experience, preferred.
• Certification as a Case Manager, preferred.
• Minimum 2 years’ experience in acute care setting.

Benefits

Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and a 401(k) match. Additional benefits include medical, dental, vision, short and long term disability benefits, life insurance, wellness programs, and financial education resources. The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level.