Nurse Care Manager II

Elevance Health•Los Angeles, CA

1d•$42 - $52•Remote

About The Position

The Nurse Care Manager II is responsible for collaborating with health plan beneficiaries and/or providers to drive personalized health management and improve health outcomes for consumers. This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Candidates should reside in compact license states.

Requirements

Requires a HS diploma or equivalent and a minimum of 3 years of acute care clinical experience, condition specific clinical experience, home health/discharge planning experience and a minimum of 1 year in a Nurse Care Mgr I role or equivalent experience; or any combination of education and experience, which would provide 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.

Nice To Haves

AS or BS in nursing preferred.
Certification as a Case Manager is preferred.
Prior managed care experience preferred.
Knowledge of medical management process and ability to interpret and apply member contracts, member benefits, and managed care products strongly preferred.
Bilingual Spanish preferred.
NICU and high-risk OB experience preferred.

Responsibilities

Provide quality case management to health plan beneficiaries to assess, plan, and support improvement in member’s functioning and health outcomes
Assists members in identifying appropriate medical needs, ensuring access to resources and services, address social determinants of health, and facilitate safe care transitions
Coordinate with internal and external partners to collaborate on members’ care
May be required to obtain licenses in multiple states to better support members across the country
Conducts clinical assessment to develop goals that address individual needs in order to develop a care plan; implements and coordinates a care plan.
Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
Assists with development of case management policies and procedures.
Participates in or leads intradepartmental teams, projects, and initiatives.