Telephonic Nurse Case Manager II
Company: Elevance Health
Location: Atlanta
Posted on: October 7, 2024
Job Description:
Location: This is a virtual position. Prefer candidates reside
within 50 miles of an Elevance Health Pulse Point location.Hours:
Monday - Friday 10:00am to 6:30pm EST with 1 evening shift twice
per month 11:30am to 8:00pm EST.
- This position will service members in different states;
therefore, Multi-State Licensure will be required.The Telephonic
Nurse Case Manager II is responsible for care management within the
scope of licensure for members with complex and chronic care needs
by assessing, developing, implementing, coordinating, monitoring,
and evaluating care plans designed to optimize member health care
across the care continuum. Performs duties telephonically.How You
Will Make An Impact
- 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.
- Interfaces with Medical Directors and Physician Advisors on the
development of care management treatment plans.
- Negotiates rates of reimbursement, as applicable.
- Assists in problem solving with providers, claims or service
issues.
- Assists with development of utilization/care management
policies and procedures.Minimum Requirements
- Requires BA/BS in a health-related field and minimum of 5 years
of clinical experience; or any combination of education and
experience, which would provide an equivalent background.
- Current, unrestricted RN license in applicable state
required.
- Multi-state licensure is required if this individual is
providing services in multiple states.Preferred Capabilities,
Skills And Experiences
- Certification as a Case Manager is preferred.
- Minimum 2 years' experience in acute care setting.
- Managed Care experience.
- Ability to talk and type at the same time.
- Demonstrate 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.For candidates working in person or
remotely in the below location(s), the salary* range for this
specific position is $75,684 to $124,338.Locations: California;
Colorado; Maryland; New YorkIn addition to your salary, Elevance
Health offers benefits such as, a comprehensive benefits package,
incentive and recognition programs, equity stock purchase and 401k
contribution (all benefits are subject to eligibility
requirements). The salary offered for this specific position is
based on a number of legitimate, non-discriminatory factors set by
the Company. The Company is fully committed to ensuring equal pay
opportunities for equal work regardless of gender, race, or any
other category protected by federal, state, and local pay equity
laws.
- The salary range is the range Elevance Health in good faith
believes is the range of possible compensation for this role at the
time of this posting. This range may be modified in the future and
actual compensation may vary from posting based on geographic
location, work experience, education and/or skill level. Even
within the range, the actual compensation will vary depending on
the above factors as well as market/business considerations. No
amount is considered to be wages or compensation until such amount
is earned, vested, and determinable under the terms and conditions
of the applicable policies and plans. The amount and availability
of any bonus, commission, benefits, or any other form of
compensation and benefits that are allocable to a particular
employee remains in the Company's sole discretion unless and until
paid and may be modified at the Company's sole discretion,
consistent with the law.Please be advised that Elevance Health only
accepts resumes for compensation from agencies that have a signed
agreement with Elevance Health. Any unsolicited resumes, including
those submitted to hiring managers, are deemed to be the property
of Elevance Health.Who We AreElevance Health is a health company
dedicated to improving lives and communities - and making
healthcare simpler. We are a Fortune 25 company with a longstanding
history in the healthcare industry, looking for leaders at all
levels of the organization who are passionate about making an
impact on our members and the communities we serve.How We WorkAt
Elevance Health, we are creating a culture that is designed to
advance our strategy but will also lead to personal and
professional growth for our associates. Our values and behaviors
are the root of our culture. They are how we achieve our strategy,
power our business outcomes and drive our shared success - for our
consumers, our associates, our communities and our business.We
offer a range of market-competitive total rewards that include
merit increases, paid holidays, Paid Time Off, and incentive bonus
programs (unless covered by a collective bargaining agreement),
medical, dental, vision, short and long term disability benefits,
401(k) +match, stock purchase plan, life insurance, wellness
programs and financial education resources, to name a few.Elevance
Health operates in a Hybrid Workforce Strategy. Unless specified as
primarily virtual by the hiring manager, associates are required to
work at an Elevance Health location at least once per week, and
potentially several times per week. Specific requirements and
expectations for time onsite will be discussed as part of the
hiring process. Candidates must reside within 50 miles or 1-hour
commute each way of a relevant Elevance Health location.The health
of our associates and communities is a top priority for Elevance
Health. We require all new candidates in certain
patient/member-facing roles to become vaccinated against COVID-19.
If you are not vaccinated, your offer will be rescinded unless you
provide an acceptable explanation. Elevance Health will also follow
all relevant federal, state and local laws.Elevance Health is an
Equal Employment Opportunity employer and all qualified applicants
will receive consideration for employment without regard to age,
citizenship status, color, creed, disability, ethnicity, genetic
information, gender (including gender identity and gender
expression), marital status, national origin, race, religion, sex,
sexual orientation, veteran status or any other status or condition
protected by applicable federal, state, or local laws. Applicants
who require accommodation to participate in the job application
process may contact elevancehealthjobssupport@elevancehealth.com
for assistance.
Keywords: Elevance Health, Athens , Telephonic Nurse Case Manager II, Executive , Atlanta, Georgia
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