Pediatric Nurse Case Manager I
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Tampa • Florida • 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
- Assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum
- Performing duties telephonically or on-site for discharge planning
- Ensuring member access to services appropriate to their health needs
- Conducting assessments to identify individual needs and specific care management plan
- Implementing care plan by facilitating authorizations/referrals as appropriate
- Coordinating internal and external resources to meet identified needs
- Monitoring and evaluating effectiveness of the care management plan
- Modifying care plans as necessary
- Interface with Medical Directors and Physician Advisors on care management treatment plans
- Assisting 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 providing services in multiple states
- Bilingual candidates strongly preferred
- 2+ years of experience with the pediatric population strongly preferred
- 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 & Tools
care managementcare plan developmentdischarge planningassessmentsauthorizationsreferralsmonitoringevaluating care plansproblem solving
Soft Skills
communicationcoordinationinterpersonal skills
Certifications
RN licenseCase Manager certification