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Nurse Case Manager I
Elevance Health. Perform care management within the scope of licensure for members with complex and chronic care needs .
About the role
Key responsibilities & impact- Perform care management within the scope of licensure for members with complex and chronic care needs
- Assess members and develop, implement, coordinate, monitor, and evaluate care plans
- Optimize member healthcare across the care continuum
- Ensure member access to services appropriate to their health needs
- Facilitate authorizations and referrals within the benefits structure or through extra-contractual arrangements
- Coordinate internal and external resources to meet identified needs
- Interface with Medical Directors and Physician Advisors on care management treatment plans
- Negotiate reimbursement rates, as applicable
- Assist with provider, claims, or service issue problem solving
- Perform duties telephonically or on-site, including hospital discharge planning
Requirements
What you’ll need- BA/BS in a health-related field and minimum of 3 years of clinical experience, or any combination of education and experience providing an equivalent background
- Current, unrestricted and active RN license in applicable state(s)
- Multi-state licensure required when providing services in multiple states
- Certification as a Case Manager preferred
- BS in a health or human services-related field preferred
- 4 years of Oncology experience preferred
- Availability Monday–Friday, 8:30am–5:00pm CST
- Candidates must reside within a reasonable commuting distance from the posting location(s), unless accommodation is granted as required by law
- New candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza, unless an acceptable explanation is provided
Benefits
Comp & perks- $3,000 sign-on bonus
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical, dental, and vision benefits
- Short- and long-term disability benefits
- 401(k) with company match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Virtual full-time work, except for required in-person training sessions
- Work-life integration and flexible autonomy