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Nurse Case Manager I – RN
Elevance Health. Perform care management within scope of licensure for members with complex and chronic care needs .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care management for members with complex and chronic care needs, including assessment, care plan development, and coordination of services. Holds a current RN license and possesses strong case management skills, with a focus on effective communication and collaboration with healthcare providers.
Highest-signal resume keywords
RN LicenseCase Management CertificationClinical ExperienceCare Plan DevelopmentHome Health Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care ManagementAssessmentCare Plan CoordinationUtilization ManagementHospital Discharge Planning
Soft Skills
CommunicationCollaborationProblem-Solving
Certifications & Qualifications
Case Manager Certification
Industry Keywords
Chronic CareTelephonic Care ManagementMember AccessAuthorization FacilitationMulti-State Licensure
About the role
Key responsibilities & impact- Perform care management within scope of licensure for members with complex and chronic care needs
- Assess members and develop, implement, coordinate, monitor, and evaluate care plans
- Ensure member access to services appropriate to health needs
- Conduct assessments to identify individual needs and care-management objectives and goals
- Facilitate authorizations and referrals within the benefits structure or through extra-contractual arrangements
- Coordinate internal and external resources to meet identified needs
- Monitor and evaluate care-plan effectiveness and modify plans as necessary
- Interface with Medical Directors and Physician Advisors on care-management treatment plans
- Assist with provider, claims, or service issues
- Perform duties telephonically
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, which would provide an equivalent background
- Current, unrestricted RN license in applicable state(s) required
- Multi-state licensure required upon hire
- Certification as a Case Manager is preferred
- Previous case management experience
- Home health experience, utilization management and/or hospital discharge planning experience is a plus
- Ability to work Monday–Friday, 9:00 am–5:30 pm EST, with two to four late evening shifts per month from 11:30 am–8:00 pm EST
- Candidates must reside within a reasonable commuting distance from the posting location(s), unless an 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- Comprehensive benefits package
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short-term disability benefits
- Long-term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Virtual full-time work, except for required in-person training sessions
- Incentive and recognition programs
- Equity stock purchase