Telephonic Nurse Case Manager I

Elevance Health • Tampa, FL

1d • $67,200 - $115,920 • Remote

About The Position

The Telephonic Nurse Case Manager I performs telephonic 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’ health care across the care continuum. It is primarily virtual full-time, with required in-person training sessions; candidates must be within reasonable commuting distance of the posting location unless an accommodation is granted. The position serves members in multiple states and requires multi-state licensure. The schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m. EST, with two evenings per month. The posted salary range for candidates working in New Jersey or Virginia is $67,200 to $115,920.

Requirements

• A BA/BS 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.

Responsibilities

• Ensure members have access to services appropriate to their health needs.
• Conduct assessments to identify individual needs and establish 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 the effectiveness of care management plans and modify them 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

• Comprehensive benefits package, subject to eligibility requirements.
• Incentive and recognition programs.
• Equity stock purchase plan.
• 401(k) contribution.
• 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) matching.
• Life insurance.
• Wellness programs.
• Financial education resources.

What This Job Offers

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