Elevance Health
Base Pay Range
$76,944.00/yr - $115,416.00/yr
Location & Work Schedule Work virtually full-time with required in-person training sessions. This role provides maximum flexibility and autonomy. Work schedule Monday to Friday 9:00 AM to 5:30 PM EST, with 2-4 late evening shifts per month from 11:30 AM to 8:00 PM EST.
Responsibilities
Ensures member access to services appropriate to their health needs.
Conducts assessments to identify individual needs and develops a specific care management plan.
Implements care plan by facilitating authorizations/referrals 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
BA/BS in a health‑related field and minimum of 5 years of clinical experience; or equivalent combination of education and experience.
Current unrestricted RN license in applicable state(s) required.
Multi‑state licensure required if providing services in multiple states.
Preferred Experience, Skills, and Capabilities
Certification and experience as a Case Manager preferred.
BS in a health or human services related field preferred.
Experience in telephonic case management for complex and chronic care needs strongly preferred.
Proficiency with telephonic systems and health information technology.
Benefits Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution. The company is fully committed to equal pay opportunities under applicable pay equity laws.
Equal Employment Opportunity Statement 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, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other protected class. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
#J-18808-Ljbffr
Location & Work Schedule Work virtually full-time with required in-person training sessions. This role provides maximum flexibility and autonomy. Work schedule Monday to Friday 9:00 AM to 5:30 PM EST, with 2-4 late evening shifts per month from 11:30 AM to 8:00 PM EST.
Responsibilities
Ensures member access to services appropriate to their health needs.
Conducts assessments to identify individual needs and develops a specific care management plan.
Implements care plan by facilitating authorizations/referrals 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
BA/BS in a health‑related field and minimum of 5 years of clinical experience; or equivalent combination of education and experience.
Current unrestricted RN license in applicable state(s) required.
Multi‑state licensure required if providing services in multiple states.
Preferred Experience, Skills, and Capabilities
Certification and experience as a Case Manager preferred.
BS in a health or human services related field preferred.
Experience in telephonic case management for complex and chronic care needs strongly preferred.
Proficiency with telephonic systems and health information technology.
Benefits Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution. The company is fully committed to equal pay opportunities under applicable pay equity laws.
Equal Employment Opportunity Statement 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, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other protected class. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
#J-18808-Ljbffr