Nurse Case Manager I

Telephonic Nurse Case Manager I Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions. Work schedule: Monday‑Friday, 10:00‑6:30 pm EST. Responsibilities Ensures member access to services appropriate to their health needs. 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. Negotiates rates of reimbursement, as applicable. Assists in problem solving with providers, claims or service issues. Minimum Requirements Requires BA/BS in a health‑related field and minimum of 3 years of clinical experience; or any combination of education and experience providing 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. Preferred Skills & Experience Certification as a Case Manager is preferred. Certification as a Case Manager and a BS in a health or human services related field preferred. Transplant experience is preferred. Salary & Benefits Salary range: $70,560 to $110,880 (positions located in Nevada and Colorado). Benefits include: comprehensive benefits package, incentive and recognition programs, equity stock purchase, 401(k) contribution, medical, dental, vision, short and long‑term disability benefits, paid holidays, paid time off, and wellness programs. Eligibility requirements apply. 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 (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact View email address on click.appcast.io for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration ( ). #J-18808-Ljbffr Elevance Health