Telephonic Nurse Case Manager II
Elevance Health
About This Role
The Telephonic Nurse Case Manager II is responsible for care management for members with complex and chronic care needs, focusing on assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. This role is ideal for experienced nurses seeking a flexible, virtual work environment.
Highlights
- Pay: $75,680 - $119,196/year
- Location: Latham, NY
- Schedule: Full-time, Monday–Friday, 8:30 AM to 5:00 PM with 2–4 late shifts per month
What You'll Do
- Ensure member access to services appropriate to their health needs
- Conduct assessments to identify individual needs and develop care management plans
- Implement care plans by facilitating authorizations/referrals as appropriate
- Coordinate internal and external resources to meet identified needs
- Monitor and evaluate the effectiveness of care management plans and modify as necessary
- Interface with Medical Directors and Physician Advisors on treatment plans
- Negotiate rates of reimbursement, as applicable
- Assist in problem solving with providers, claims, or service issues
- Assist with the development of utilization/care management policies and procedures
Requirements
Education:
- BA/BS in a health-related field required
Experience:
- Minimum of 5 years of clinical experience required
- Minimum 2 years’ experience in an acute care setting preferred
Licenses & Certifications:
- Current, unrestricted RN license in applicable state required
- Multi-state licensure required if providing services in multiple states
- Certification as a Case Manager preferred
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase and 401k contribution
About Elevance Health
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. They are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels who are passionate about making an impact on their members and communities.
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