Nurse Case Manager II
Elevance Health
Nurse Case Manager I, NICU
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Indianapolis • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Performs 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.
- Performs duties telephonically.
- 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 management 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.
Requirements
- Requires BA/BS in a health related field and minimum of 3 years of relative clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current, unrestricted RN license in applicable state(s) required.
- Multi-state licensure is required if this individual is providing services in multiple states.
- Case Management experience is preferred.
- Certification as a Case Manager is preferred.
- Minimum 3 years experience in acute care setting preferred.
- Managed Care experience is preferred.
- Ability to talk and type at the same time.
- Demonstrate critical thinking skills when interacting with members.
- Strong computer skills (including 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.
- Strong organization and time management skills with the ability to work independently.
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
ATS Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
care managementassessmentscare plansauthorizationsreferralsproblem solvingcritical thinkingacute care experiencemanaged care experiencecase management
Soft skills
communicationorganizationtime managementindependence
Certifications
RN licenseCase Manager certification
