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Telephonic Nurse Case Manager I
Elevance Health. Provide telephonic care management within the 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 telephonic care management, including assessment, development, and coordination of care plans for members with complex health needs. Proficient in critical thinking and communication, ensuring effective interaction with members and healthcare providers.
Highest-signal resume keywords
RN LicenseTelephonic Care ManagementCare Plan DevelopmentClinical ExperienceCase Management Certification
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 ImplementationUtilization ManagementCritical Thinking
Soft Skills
CommunicationInterpersonal SkillsTime Management
Tools & Technologies
Microsoft OfficeComputer ProgramsHealthcare Software
Certifications & Qualifications
Case Manager Certification
Industry Keywords
Chronic Care ManagementMultistate LicensureHealth-Related FieldProvider CoordinationAuthorization Facilitation
About the role
Key responsibilities & impact- Provide telephonic 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
- Ensure member access to services appropriate to health needs
- Facilitate authorizations and referrals within the benefits structure or through extra-contractual arrangements
- Coordinate internal and external resources to meet identified needs
- Monitor and modify care management plans as necessary
- Interface with Medical Directors and Physician Advisors on care management treatment plans
- Assist with provider, claims, or service issues
- Assist with development of utilization and care management policies and procedures
- Service members in different states
Requirements
What you’ll need- BA/BS in a health-related field required
- 3 years of clinical experience; or any combination of education and experience providing an equivalent background
- Current, unrestricted RN license from the State of Georgia required
- Multistate licensure required when providing services in multiple states
- Ability to talk and type at the same time
- Certification as a Case Manager preferred
- Critical thinking skills when interacting with members
- Experience with Microsoft Office and/or ability to learn new computer programs, systems, and software quickly
- Ability to manage, review, and respond to emails/instant messages in a timely fashion
- Must reside in the State of Georgia
- Must be within a reasonable commuting distance from the posting location(s), unless an accommodation is granted
- Must complete the online pre-employment skills assessment within 48 hours of receipt and meet the criteria
Benefits
Comp & perks- 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 work flexibility
- Professional growth opportunities