Remote RN Case Manager II - Chronic Care & Discharge

RN Nurse Case Manager ll (California HMO) (JR191246) Location – Virtual: Supports virtual work full-time with required in-person training. Candidates must reside within commuting distance to an office or be willing to travel. Work Hours – Pacific Time: 8 hour shift within 8am–6pm PST. Job Summary: The Nurse Case Manager performs care management for members with complex and chronic care needs, assessing, developing, coordinating, monitoring, and evaluating care plans to optimize health outcomes. Primary duties include telephonic coordination with medical groups, providers, community resources, and members for discharge planning. Responsibilities Ensures member access to services appropriate to their health needs. Conducts assessments to identify individual needs and design care management plans. Implements care plans by facilitating authorizations/referrals within benefits structure. Coordinates internal and external resources to meet identified needs. Monitors and evaluates effectiveness of care plans and modifies as necessary. Interfaces with Medical Directors and Physician Advisors on treatment plans. Assists with problem solving with providers, claims or service issues. Assists with development of utilization/care management policies and procedures. Minimum Requirements BA/BS in a health-related field and minimum of 5 years of clinical experience or equivalent education/experience. Current, unrestricted RN license in California. Preferred Skills, Capabilities & Experiences Case Manager experience within hospital or managed care setting. Clinical experience with individuals with chronic diseases, illnesses, and medical needs. Knowledge or experience with discharge planning. Certification as a Case Manager. Salary: $83,248 – $136,224 (California) Benefits: Comprehensive benefits package including health, dental, vision, disability, 401(k) with match, equity stock purchase plan, and wellness resources. Equal Employment Opportunity Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by applicable laws. Applicants who require accommodation to participate in the job application process may contact View email address on click.appcast.io for assistance. #J-18808-Ljbffr Elevance Health