Senior Nurse Case Manager – Field Nurse
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Albany • 🇺🇸 United States
Visit company websiteJob Level
Senior
About the role
- Ensures member access to services appropriate to their health needs
- Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment
- Implements care plan by facilitating authorizations/referrals as appropriate 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
- Assists in problem solving with providers, claims or service issues
- Coordinate referrals to local and statewide resources including behavioral health, housing, transportation, and food assistance
- Partner with community health organizations, advocacy groups, and outreach teams to strengthen member connections
- Plan, coordinate, and deliver educational events in collaboration with community partners, employers, or local health organizations
- Provide group-based and one-on-one education on chronic conditions, medication adherence, preventive screenings, nutrition, and self-care
- Support initiatives that address health equity and promote culturally responsive care
- Assists with development of utilization/care management policies and procedures, chairs and schedules meetings, presents cases for discussion at Grand Rounds/Care Conferences and participates in interdepartmental and/or cross brand workgroups
- May require the development of a focused skill set including comprehensive knowledge of specific disease process or traumatic injury and functions as preceptor for new care management staff
- Participates in department audit activities
Requirements
- Requires BA/BS in a health-related field and minimum of 5 years of clinical experience
- Current, unrestricted RN license in applicable state(s) required
- Nursing experience in Home Health, Managed Care, Case Management, or Care Coordination preferred
- Case Management Certification preferred
- Strong communication and presentation skills
Benefits
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical, dental, vision benefits
- Short and long term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
care managementclinical assessmentcare plan implementationproblem solvingeducation on chronic conditionsmedication adherencepreventive screeningsnutritionself-careutilization management
Soft skills
communication skillspresentation skillscoordinationcollaborationproblem solvingorganizational skillsleadershipcultural competencyadvocacycommunity engagement
Certifications
RN licenseCase Management Certification