Elevance Health
Nurse Case Manager II
at
Elevance Health
Base pay range $76,944.00/yr - $115,416.00/yr
Location:
New York (virtual with required in‑person training sessions)
Work Schedule: Monday to Friday 9:00 AM to 5:30 PM EST, with 2‑4 late even‑ing shifts per month from 11:30 AM to 8:00 PM EST.
How You Will Make An Impact
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.
Implements 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. Assists with development of utilization/care management policies and procedures.
Minimum Requirements
Requires BA/BS in a health‑related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
Current unrestricted RN license in applicable state(s) required.
Multi‑state licensure is required if this individual provides services in multiple states.
Preferred Experience, Skills, And Capabilities
Certification and experience as a Case Manager is preferred.
BS in a health or human services related field preferred.
Experience in telephonic case management, especially for complex and chronic care needs is strongly preferred.
Preferred proficiency with telephonic systems and health information technology.
Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. Benefits are subject to eligibility requirements.
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. 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.
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at
Elevance Health
Base pay range $76,944.00/yr - $115,416.00/yr
Location:
New York (virtual with required in‑person training sessions)
Work Schedule: Monday to Friday 9:00 AM to 5:30 PM EST, with 2‑4 late even‑ing shifts per month from 11:30 AM to 8:00 PM EST.
How You Will Make An Impact
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.
Implements 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. Assists with development of utilization/care management policies and procedures.
Minimum Requirements
Requires BA/BS in a health‑related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
Current unrestricted RN license in applicable state(s) required.
Multi‑state licensure is required if this individual provides services in multiple states.
Preferred Experience, Skills, And Capabilities
Certification and experience as a Case Manager is preferred.
BS in a health or human services related field preferred.
Experience in telephonic case management, especially for complex and chronic care needs is strongly preferred.
Preferred proficiency with telephonic systems and health information technology.
Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. Benefits are subject to eligibility requirements.
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. 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.
#J-18808-Ljbffr