Nurse Case Manager 1 100% Virtual, Carebridge

Elevance Health • Grand Prairie, TX

1d • Remote

About The Position

CareBridge Health, part of the Elevance Health family of companies within Carelon, seeks a Nurse Case Manager I to support members with complex and chronic care needs. The role performs care management within the scope of the nurse’s licensure, including assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize members’ health care across the care continuum. Work is performed primarily by telephone, with occasional on-site duties such as hospital discharge planning.

This is a full-time virtual role, except for required in-person training sessions. Candidates generally must live within a reasonable commuting distance of an office unless an accommodation is granted. The schedule is Monday through Friday, 11 a.m. to 8 p.m. CST.

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 is preferred.
• Prior case management experience is strongly preferred.
• Home health experience is strongly preferred.

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 benefit structures or through extra-contractual arrangements.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate care plan effectiveness, modifying plans as necessary.
• Work with Medical Directors and Physician Advisors to develop care management treatment plans.
• Negotiate reimbursement rates, as applicable.
• Help resolve provider, claims, or service issues.
• Perform care management duties telephonically or on-site, including hospital discharge planning.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs, unless covered by a collective bargaining agreement
• Medical insurance
• Dental insurance
• Vision insurance
• Short- and long-term disability benefits
• 401(k) with match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level