FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Telephonic Nurse Case Manager II
Elevance Health. Provide 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 care management for members with complex and chronic needs, including assessment, care plan development, and coordination of services. Holds a current RN license and certification as a Case Manager, with a strong background in clinical settings and multi-state licensure.
Highest-signal resume keywords
RN LicenseCase Management ExperienceCertification as a Case ManagerAcute Care ExperienceMulti-State Licensure
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 Plan DevelopmentAssessment SkillsCare Management CoordinationMonitoring and EvaluationNegotiation Skills
Soft Skills
Effective CommunicationTimely Email Management
Tools & Technologies
Microsoft OfficeComputer Programs
Certifications & Qualifications
Case Manager Certification
Industry Keywords
Chronic Care ManagementUtilization ManagementHealth Needs AssessmentTelephonic ServicesReimbursement Negotiation
About the role
Key responsibilities & impact- Provide 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
- Conduct assessments to identify individual needs and care management objectives
- 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 management plan effectiveness and modify plans as necessary
- Interface with Medical Directors and Physician Advisors on care management treatment plans
- Negotiate reimbursement rates as applicable
- Assist with provider, claims, or service issues
- Assist with development of utilization/care management policies and procedures
- Perform duties telephonically
- Service members in different states
Requirements
What you’ll need- BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience providing an equivalent background
- Current, unrestricted RN license in applicable state required
- Multi-state licensure required when providing services in multiple states
- Case Management experience
- Certification as a Case Manager
- Minimum 2 years’ experience in acute care setting
- Experience with Microsoft Office and/or ability to learn new computer programs/systems/software quickly
- Ability to manage, review and respond to emails/instant messages in a timely fashion
- Candidates must reside within a reasonable commuting distance from the posting location(s), unless an accommodation is granted
- 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
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution / 401(k) + match
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short-term disability benefits
- Long-term disability benefits
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Virtual work flexibility
- Professional and personal growth opportunities