Workday Manager
Grant Thornton (US)
Telephonic Nurse Case Manager I
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Atlanta • Florida, Ohio • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Perform care management within the scope of licensure for members with complex and chronic care needs
- Assess, develop, implement, coordinate, monitor, and evaluate care plans designed to optimize member health care across the care continuum
- Ensure member access to services appropriate to their health needs
- Conduct assessments to identify individual needs and a specific care management plan
- Implement care plan by facilitating authorizations/referrals
- Coordinate internal and external resources to meet identified needs
- Monitor and evaluate effectiveness of the care management plan and modify as necessary
- Interface with Medical Directors and Physician Advisors on care management treatment plans
- Negotiate rates of reimbursement, as applicable
- Assist in problem solving with providers, claims or service issues
Requirements
- Requires BA/BS in a health related field and minimum of 3 years of clinical experience
- Current, unrestricted RN license in applicable state(s) required
- Multi-state licensure is required if this individual is providing services in multiple states
- Certification as a Case Manager is preferred
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- 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 managementcare plan developmentassessmentcoordination of caremonitoring and evaluationauthorization facilitationnegotiationproblem solving
Soft skills
interpersonal skillscommunication skillsorganizational skills
Certifications
RN licenseCase Manager certification
