Nurse Case Mgr I
Elevance Health, Houston, TX, United States
Telephonic Nurse Case Manager I
Sign on Bonus:
$3000
Location:
Virtual (full‑time). Required in‑person training sessions may be required. Alternate locations may be considered for candidates within commuting distance of an office.
Hours:
Monday - Friday 10:30 AM – 7:00 PM CST.
Multi‑State Licensure:
Required if providing services in multiple states.
Responsibilities
Ensure members have access to services appropriate to their health needs.
Conduct assessments to identify individual needs and develop specific care management plans.
Implement care plans by facilitating authorizations/referrals within benefits structure or through extra‑contractual arrangements.
Coordinate internal and external resources to meet identified needs.
Monitor and evaluate effectiveness of care management plans and modify as necessary.
Interface with Medical Directors and Physician Advisors on development of care management treatment plans.
Negotiate rates of reimbursement and assist in problem‑solving with providers, claims, or service issues.
Minimum Requirements
BA/BS in a health‑related field and a minimum of 3 years of clinical experience, or equivalent education and experience.
Current, unrestricted RN license in applicable state(s).
Multi‑state licensure if providing services in multiple states.
Preferred Capabilities, Skills and Experiences
Case management experience.
Minimum 2 years’ experience in an acute care setting.
Managed care experience.
Ability to talk and type simultaneously.
Critical thinking skills when interacting with members.
Proficiency with Microsoft Office and quick learning of new computer programs/systems/software.
Ability to manage and respond to emails/instant messages in a timely fashion.
Additional Employment Conditions
Elevance Health operates a hybrid workforce strategy. Unless specified as primarily virtual by the hiring manager, associates must work at an Elevance Health location at least once per week.
Employees in patient/member‑facing roles must be vaccinated against COVID‑19 and influenza. Unvaccinated applicants will have their offers rescinded unless a valid exemption is provided.
Benefits
We offer a range of market‑competitive total rewards, including merit increases, paid holidays, Paid Time Off, incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long‑term disability benefits, 401(k) with matching, stock purchase plan, life insurance, wellness programs, and financial education resources.
Equal Employment Opportunity Statement
Elevance Health is an Equal Employment Opportunity employer. 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.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration (https://info.flclearinghouse.com/).
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Sign on Bonus:
$3000
Location:
Virtual (full‑time). Required in‑person training sessions may be required. Alternate locations may be considered for candidates within commuting distance of an office.
Hours:
Monday - Friday 10:30 AM – 7:00 PM CST.
Multi‑State Licensure:
Required if providing services in multiple states.
Responsibilities
Ensure members have access to services appropriate to their health needs.
Conduct assessments to identify individual needs and develop specific care management plans.
Implement care plans by facilitating authorizations/referrals within benefits structure or through extra‑contractual arrangements.
Coordinate internal and external resources to meet identified needs.
Monitor and evaluate effectiveness of care management plans and modify as necessary.
Interface with Medical Directors and Physician Advisors on development of care management treatment plans.
Negotiate rates of reimbursement and assist in problem‑solving with providers, claims, or service issues.
Minimum Requirements
BA/BS in a health‑related field and a minimum of 3 years of clinical experience, or equivalent education and experience.
Current, unrestricted RN license in applicable state(s).
Multi‑state licensure if providing services in multiple states.
Preferred Capabilities, Skills and Experiences
Case management experience.
Minimum 2 years’ experience in an acute care setting.
Managed care experience.
Ability to talk and type simultaneously.
Critical thinking skills when interacting with members.
Proficiency with Microsoft Office and quick learning of new computer programs/systems/software.
Ability to manage and respond to emails/instant messages in a timely fashion.
Additional Employment Conditions
Elevance Health operates a hybrid workforce strategy. Unless specified as primarily virtual by the hiring manager, associates must work at an Elevance Health location at least once per week.
Employees in patient/member‑facing roles must be vaccinated against COVID‑19 and influenza. Unvaccinated applicants will have their offers rescinded unless a valid exemption is provided.
Benefits
We offer a range of market‑competitive total rewards, including merit increases, paid holidays, Paid Time Off, incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long‑term disability benefits, 401(k) with matching, stock purchase plan, life insurance, wellness programs, and financial education resources.
Equal Employment Opportunity Statement
Elevance Health is an Equal Employment Opportunity employer. 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.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration (https://info.flclearinghouse.com/).
#J-18808-Ljbffr