Manager responsible for overseeing revenue integrity operations within INTEGRIS Health facilities. Ensures financial performance and compliance in healthcare billing and coding processes.
About the role
- 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
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
- paid time off
- merit increases
- medical, dental, vision benefits
- short and long term disability benefits
- wellness programs
- financial education resources
Job title
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