Nurse Case Manager I

Position Nurse Case Manager I The position will be based in Latham, New York; Seven Hills, Ohio; Norfolk, Virginia; and Columbus, Georgia. This role is eligible for virtual work with required in-person training sessions. Per policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting locations will not be considered unless an accommodation is granted as required by law. Location and Work Arrangements The Elevance Health Companies, Inc. Nurse Case Manager I location allows associates to work virtually full-time, with in-person onboarding and skill development as needed. The position will be based on Latham, NY; Seven Hills, OH; Norfolk, VA; and Columbus, GA. Hybrid/virtual work policy applies as described above. Schedule This position will work an 8-hour shift from 8:00 am to 8:00 pm (EST), Monday to Friday. Additional hours may be necessary based on company needs. Responsibilities The Nurse Case Manager I is 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. Duties may include care coordination for discharge planning and performing activities telephonically or on-site as needed. Ensure member access to services appropriate to their health needs. Conduct assessments to identify individual needs and develop a care management plan with objectives and goals identified during assessment. Implement care plans by facilitating authorizations/referrals within the benefits structure or through extra-contractual arrangements. Coordinate internal and external resources to meet identified needs. Monitor and evaluate the effectiveness of the care management plan and modify as necessary. Interface with Medical Directors and Physician Advisors on care management treatment plans. Negotiate rates of reimbursement, as applicable. Assist in problem solving with providers, claims, or service issues. Minimum Requirements Requires BA/BS in a health-related field and a minimum of 3 years of clinical experience; or any combination of education and experience that provides an equivalent background. Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this individual provides services in multiple states. Preferred Skills, Capabilities, and Experiences Certification as a Case Manager is preferred. For URAC-accredited areas the following applies: requires BA/BS and 3 years of clinical care experience; or an equivalent background. Current and active RN license required in applicable state(s). Multi-state licensure is required if providing services in multiple states. Certification as a Case Manager and a BS in a health or human services related field are preferred. For candidates working in person or virtually in the locations above, the salary range for this position is $70,000 to $105,000. Salary, Benefits, and Work Policy Locations: Latham, NY. Elevance Health offers a range of benefits including comprehensive benefits, incentive programs, equity stock purchase and 401(k) contribution (subject to eligibility). The offered salary is based on legitimate, non-discriminatory factors and may be adjusted for geographic location, experience, education, and skills. Equal pay opportunities apply for equal work, regardless of gender, race, or other protected categories. The salary range may be modified in the future; actual compensation varies by factors including location, experience, and market conditions. The company may require resumes only from agencies with signed agreements. Elevance Health is an Equal Employment Opportunity employer. All qualified applicants will receive consideration 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 protected status. Accommodation requests for the job application process may be directed to View email address on click.appcast.io. Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws. Florida applicants should review HB531 materials. #J-18808-Ljbffr Elevance Health