Nurse Care Manager I

Nurse Care Manager I

Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Location: Columbus, Cincinnati, Mason, Seven Hills, OH, Louisville, KY, St. Louis, MO and Waukesha, WI. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Work Schedule: Monday - Friday. Flexible hours between 8am-7pm EST. No weekends or holidays.

The Nurse Care Manager I will be responsible for performing 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.

How you will make an impact:

• Ensures member access to services appropriate to their health needs.
• Coordinates internal and external resources to meet identified needs.
• Partners with physician clinical reviewers and/or medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance.
• Collaborates with providers to assess consumer needs for early identification of and proactive planning for discharge.
• Conducts clinical assessment to develop goals that address individual needs in order to develop and implement a care plan.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary.

Minimum Requirements:

• Requires a HS diploma or equivalent and a minimum of 3 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current, active valid unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if this individual is providing services in multiple states.

Preferred Skills, Capabilities and Experiences:

• Home health/discharge planning experience preferred.
• AS or BS in nursing preferred.
• Previous utilization management experience preferred.
• Prior case management experience preferred.
• Certification as a Case Manager is preferred.

For URAC accredited areas, the following applies:

• Current and active RN license required in applicable state(s) that allows for an independent assessment to be conducted within their scope of practice.
• Requires 3 years full-time equivalent of direct clinical care experience to the consumer, 5 years full-time equivalent of direct clinical care experience to the consumer preferred or any combination of education and experience, which would provide an equivalent background.
• Multi-state licensure is required if this individual is providing services in multiple states.
• Certification as a Case Manager or a BS in a health or human services related field also preferred.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $32.30 p/h- 40.38 p/h.

Location: Columbus, OH.

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

Job Level: Non-Management Non-Exempt

Workshift:

Job Family: MED > Licensed Nurse