Telephonic RN Nurse Case Manager I at Elevance Health managing care for members with complex health needs. Assessing and coordinating care plans while supporting member health across multiple locations.
Responsibilities
Performing 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
Performing duties telephonically or on-site such as at hospitals for discharge planning
Ensuring members understand benefits and assist in access of services appropriate to their health needs
Conducting assessments to identify individual needs and a specific care management plan
Implementing care plan through actions based on assessments including providing education
Coordinating internal and external resources to meet identified needs
Monitoring and evaluating effectiveness of the care management plan and modifying as necessary
Interfaces with Medical Directors and other health professionals on the development of care management treatment plans
Assisting in problem solving for members and providers related to access to care, vendors, claims or service issues
Requirements
Requires BA/BS in a health related field
Minimum of 3 years of clinical experience
Current, unrestricted compact RN license in home state
Multi-state licensure required if providing services in multiple states
Strong clinical background in hospital setting, i.e. Med Surg, ER, ICU, Critical Care
Ability to talk, type and critically think at the same time
Demonstrates critical thinking skills when interacting with members
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
Excellent collaboration, communication and teamwork skills
RN Care Manager working with patients and families to ensure smooth transitions after discharge. Collaborating with interdisciplinary teams for efficient patient care in value - based healthcare.
Spiritual Care Manager overseeing Spiritual Care services and managing chaplains at Trinity Health. Collaborating on talent development and ensuring effective delivery of care across the continuum.
Manager overseeing gas meter services and operations at Eversource Energy, ensuring safety, budget adherence, and compliance. Leading a successful team within gas distribution facilities.
Manager for Gas Meter Services overseeing gas meter service operations in Massachusetts. Ensuring safety compliance and efficient management of meter services and budgets.
Governess managing household tasks and children's activities for a private family in Paris. Responsible for coordination, supervision, and educational support for two children aged 9 and 10.
Credit Risk Manager responsible for optimizing the profitability of wholesale loan portfolio at Truist. Leading a credit approval team and executing credit strategy while ensuring compliance with regulations.
Forward Planning Manager coordinating timely planning and opening of new communities for Lennar. Ensuring organized rollout processes and exceptional customer experiences.
Nurse Care Manager providing care coordination including assessments and planning for members' health needs in New York. Engaging interdisciplinary teams to ensure quality outcomes and member advocacy.
BIM - Manager responsible for developing and implementing BIM standards and processes for construction company. Collaborating with project teams and managing BIM models across all project phases.
Market Intelligence Manager responsible for leading business strategy development at Elevance Health. Analyzing market trends and competitor strategies to optimize product lines.