Nurse Case Manager
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Norfolk • 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
- Assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum
- Conducting assessments to identify individual needs and a specific care management plan
- Facilitating authorizations/referrals as appropriate
- Coordinating internal and external resources to meet identified needs
- Monitoring and evaluating effectiveness of the care management plan and modifying as necessary
- Interfacing with Medical Directors and Physician Advisors on treatment plans
- Negotiating rates of reimbursement as applicable
- 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
- Certification as a Case Manager preferred
- BS in a health or human services related field preferred
- Previous OB/NICU experience 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 managementassessmentscare plansmonitoringevaluatingnegotiating reimbursementproblem solving
Soft Skills
coordinationcommunication
Certifications
RN licenseCase Manager certification