Nurse Case Manager I
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Atlanta • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
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
- Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans
- Assists in problem solving with providers, claims or service issues
- Assists with development of utilization/care management policies and procedures
Requirements
- Requires a BA/BS in a health-related field
- 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background
- Current, unrestricted RN license from the State of Georgia required
- Multistate licensure is required if this individual is providing services in multiple states
- Ability to talk and type at the same time
- Certification as a Case Manager (preferred)
- Demonstrate critical thinking skills when interacting with members
- 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
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
clinical experiencecare managementassessmentsproblem solvingutilization managementtreatment planscritical thinking
Soft skills
communicationcoordinationevaluationinterpersonal skillstime management
Certifications
RN licenseCase Manager certification