Telephonic Nurse Case Manager II Sign on Bonus: $2000. Location Virtual: This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. Preferred locations: Seattle, WA; Denver, CO; Costa Mesa, CA; Las Vegas, NV. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Hours Monday – Friday 9:00 am to 5:30 pm with 1–2 late evenings 11:30 am to 8:00 pm depending on your time zone. Service members are located in different states; therefore, multi‑state licensure will be required. Responsibilities Ensures member access to services appropriate to their health needs. Conducts assessments to identify individual needs and develop a specific care management plan. Implements care plan by facilitating authorizations or 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 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 BA/BS in a health‑related field and a minimum of 5 years of clinical experience; or an equivalent combination of education and experience. Current, unrestricted RN license in applicable state(s). Multi‑state licensure if this individual is providing services in multiple states. Preferred Capabilities, Skills and Experiences Case Management experience. Certification as a Case Manager. Minimum 2 years’ experience in an acute care setting. Managed Care experience. California RN license is a plus. 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 virtually in the below locations, the salary range for this specific position is $79,464 to $130,548. Locations: Colorado; Nevada; Washington State; California. In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) 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 based on geographic location, work experience, education and/or skill level. Elevance Health requires vaccination against COVID‑19 and Influenza for new candidates in certain patient/member‑facing roles. If a candidate is not vaccinated, the offer will be rescinded unless an acceptable explanation is provided. The organization follows 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. 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. #J-18808-Ljbffr Elevance Health
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