Hybrid Senior Nurse Case Manager – Field Nurse

at Elevance Health

• Job title: Senior Nurse Case Manager – Field Nurse
• Job type: Full Time
• Experience level: Senior
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Albany, United States

About the role

• Nurse Case Manager Senior responsible for assessing, developing, and coordinating member care plans. Working in the Albany, GA area to support members with complex and chronic care needs.

Responsibilities

• 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
• Assists in problem solving with providers, claims or service issues
• Coordinate referrals to local and statewide resources including behavioral health, housing, transportation, and food assistance
• Partner with community health organizations, advocacy groups, and outreach teams to strengthen member connections
• Plan, coordinate, and deliver educational events in collaboration with community partners, employers, or local health organizations
• Provide group-based and one-on-one education on chronic conditions, medication adherence, preventive screenings, nutrition, and self-care
• Support initiatives that address health equity and promote culturally responsive care
• Assists with development of utilization/care management policies and procedures, chairs and schedules meetings, presents cases for discussion at Grand Rounds/Care Conferences and participates in interdepartmental and/or cross brand workgroups
• May require the development of a focused skill set including comprehensive knowledge of specific disease process or traumatic injury and functions as preceptor for new care management staff
• Participates in department audit activities

Requirements

• Requires BA/BS in a health-related field and minimum of 5 years of clinical experience
• Current, unrestricted RN license in applicable state(s) required
• Nursing experience in Home Health, Managed Care, Case Management, or Care Coordination preferred
• Case Management Certification preferred
• Strong communication and presentation skills

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical, dental, vision benefits
• Short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources