Telephonic Nurse Case Manager II at Elevance Health providing care management for members with complex health care needs. Responsible for assessments, care planning, and coordination of services in various states.
Responsibilities
Responsible for care management within scope of licensure for members with complex and chronic care needs
Assess, develop, implement, coordinate, monitor, and evaluate care plans
Ensures member access to services appropriate to their health needs
Conduct assessments to identify individual needs
Implement care plan by facilitating authorizations/referrals
Coordinates internal and external resources to meet identified needs
Monitors and evaluates effectiveness of care management plan
Requirements
Requires BA/BS in a health related field
Minimum of 5 years of clinical experience
Current, unrestricted RN license in applicable state(s) required
Multi-state licensure is required if providing services in multiple states
Certification as a Case Manager (preferred)
Ability to talk and type at the same time
Demonstrate critical thinking skills
Minimum 2 years’ experience in acute care setting
Minimum 2 years telephonic Case Management experience with a Managed Care Company
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