Hybrid Telephonic Nurse Case Manager, I

Posted last month

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About the role

  • Telephonic Nurse Case Manager responsible for managing telephonic care for members with chronic health needs. Working for Elevance Health to optimize health care across care continuum services.

Responsibilities

  • responsible for telephonic care management within the scope of licensure for members with complex and chronic care needs
  • assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum
  • Ensures member access to services appropriate to their health needs
  • Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment
  • Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements
  • Coordinates internal and external resources to meet identified needs
  • Monitors and evaluates effectiveness of the care management plan and modifies as necessary
  • Interfaces with Medical Directors and Physician Advisor's on the development of care management treatment plans
  • Assists in problem solving with providers, claims or service issues
  • Assists with development of utilization/care management policies and procedures

Requirements

  • Requires a BA/BS in a health-related field
  • 3 years of clinical experience
  • Current, unrestricted RN license from the State of Georgia required
  • Multistate licensure is required if this individual is providing services in multiple states
  • Ability to talk and type at the same time
  • Certification as a Case Manager preferred
  • Experience with Microsoft Office and/or ability to learn new computer programs/systems/software quickly
  • Ability to manage, review and respond to emails/instant messages in a timely fashion

Benefits

  • merit increases
  • paid holidays
  • Paid Time Off
  • incentive bonus programs
  • medical benefits
  • dental benefits
  • vision benefits
  • short and long term disability benefits
  • 401(k) +match
  • stock purchase plan
  • life insurance
  • wellness programs
  • financial education resources

Job title

Telephonic Nurse Case Manager, I

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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