Senior Nurse Case Manager – Field Nurse
Elevance Health
full-time
Posted on:
Location: 🇺🇸 United States
Visit company websiteJob Level
Senior
About the role
- Assess, develop, implement, coordinate, monitor, and evaluate care plans for members with complex and chronic care needs within scope of RN licensure.
- Operate primarily in the field traveling to client sites or designated locations; occasional office attendance for meetings or training.
- Conduct assessments, identify needs, and create care management plans; facilitate authorizations/referrals.
- Coordinate internal and external resources; monitor and evaluate care plan effectiveness and modify as necessary.
- Assist in problem solving with providers, claims or service issues; coordinate referrals to behavioral health, housing, transportation, food assistance, and community resources.
- Partner with community health organizations and employers; plan, coordinate, and deliver educational events; provide group and one-on-one education on chronic conditions and preventive care.
- Support health equity and culturally responsive care initiatives; assist in development of utilization/care management policies and procedures; chair meetings and present cases at Grand Rounds/Care Conferences.
- May develop focused skill set and act as preceptor for new care management staff; participate in department audit activities.
- Position involves travel to health plan-sponsored events and presentations; does not involve in-home or facility-based visits.
Requirements
- Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
- 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. (Preferred)
- Must be within reasonable commuting distance from Macon, GA (per policy)