Nurse Case Manager 1 100% Virtual, Carebridge
About The Position
CareBridge Health, part of the Elevance Health family of companies within Carelon, works to help individuals in home and community-based settings maximize their health, independence, and quality of life. The Nurse Case Manager I performs care management within the scope of licensure for members with complex and chronic care needs. The role assesses, develops, implements, coordinates, monitors, and evaluates care plans to optimize members’ healthcare across the care continuum. Duties are performed telephonically and may also be performed on-site, such as at hospitals for discharge planning. This is a full-time virtual role, except for required in-person training sessions. Candidates must reside within a reasonable commuting distance from the posting location unless an accommodation is granted. Work hours are Monday through Friday, 11 a.m. to 8 p.m. Central Time.
Requirements
- Bachelor’s degree in a health-related field and at least 3 years of clinical experience, or an equivalent combination of education and experience.
- Current, unrestricted RN license in applicable state(s).
- Multi-state licensure if providing services in multiple states.
Nice To Haves
- Certification as a Case Manager.
- Prior case management experience.
- Home health experience.
Responsibilities
- Ensure members have access to services appropriate to their health needs.
- Conduct assessments to identify individual needs and develop care management plans with objectives and goals.
- Implement care plans by facilitating authorizations and referrals within the benefits structure or through extra-contractual arrangements.
- Coordinate internal and external resources to meet identified needs.
- Monitor and evaluate care plan effectiveness and modify plans as necessary.
- Interface with Medical Directors and Physician Advisors to develop care management treatment plans.
- Negotiate reimbursement rates, as applicable.
- Assist with problem-solving provider, claims, or service issues.
Benefits
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs, unless covered by a collective bargaining agreement
- Medical benefits
- Dental benefits
- Vision benefits
- Short- and long-term disability benefits
- 401(k) with match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
