Provider Network Manager Sr developing provider networks through contract negotiations and relationship building at Elevance Health. Requires BA/BS and 5+ years’ experience with a focus on complex providers.
About the role
- Pediatric Care Manager (RN) developing personalized care plans and facilitating healthcare outcomes for members. A hybrid role based in southern Florida requiring local visits to pediatric members.
Responsibilities
- Develops, assesses, and facilitates complex care management activities for primarily physical needs members
- Provides high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families
- Evaluates the needs of the member, barriers to accessing the appropriate care, and recommends/facilitates the plan for the best outcome
- Coordinates between the member and/or family/caregivers and the care provider team
- Provides ongoing follow up and monitoring of member status
- Provides resource support to members and care managers for local resources for various services
Requirements
- Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 – 4 years of related experience
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required
- Employees supporting Florida's Children’s Medical Services (CMS) must have a minimum of two years of pediatric experience
- May require up to 80% local travel required
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Job title
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