Telephonic RN Case Manager I
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Atlanta • Idaho • 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 such as at hospitals for discharge planning
- Ensuring members understand benefits and assist in access of services appropriate to their health needs
- Conducting assessments to identify individual needs and a specific care management plan
- Implementing care plan through actions based on assessments including providing education
- Coordinating internal and external resources to meet identified needs
- Monitoring and evaluating effectiveness of the care management plan and modifying as necessary
- Interfaces with Medical Directors and other health professionals on the development of care management treatment plans
- Assisting in problem solving for members and providers related to access to care, vendors, claims or service issues
Requirements
- Requires BA/BS in a health related field
- Minimum of 3 years of clinical experience
- Current, unrestricted compact RN license in home state
- Multi-state licensure required if providing services in multiple states
- Strong clinical background in hospital setting, i.e. Med Surg, ER, ICU, Critical Care
- Ability to talk, type and critically think at the same time
- Demonstrates 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
- Excellent collaboration, communication and teamwork skills
Benefits
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short term disability benefits
- 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 managementclinical experienceassessmentscare plansdischarge planningcritical thinkingeducation provisionmonitoring and evaluationproblem solving
Soft Skills
collaborationcommunicationteamworkability to multitasktimely response
Certifications
BA/BS in health related fieldRN licensemulti-state licensure