RN Nurse Case Manager I
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Henrico • Virginia • United States
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About the role
- Performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum.
- 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 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.
- Functions as preceptor for new care management staff.
- Works on special projects as assigned by manager.
- Other duties as assigned.
Requirements
- Requires 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current, active, unrestricted RN license from the Commonwealth of Virginia.
- Previous case management experience is preferred.
- Behavioral Health and/or experience working with individuals with intellectual/developmental disabilities is a huge plus.
- Home health experience, utilization management and/or hospital discharge planning experience is a plus.
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical benefits
- dental benefits
- 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 & Tools
care managementassessmentscare plansauthorizationsreferralsmonitoringevaluationproblem solvingcase managementutilization management
Soft Skills
coordinationcommunicationinterpersonal skillsleadershiporganizational skills
Certifications
RN licenseCommonwealth of Virginia