Job Description

Telephonic Nurse Case Manager II (CA) Sign on Bonus: $5000 Location: This role enables associates to work virtually full-time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. Must reside in California. Hours: Monday - Friday 9:00 am to 5:30 pm with 1–2 late evenings 11:30 am to 8:00 pm PST. 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/referrals as appropriate within benefits structure. 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 that provides an equivalent background. Current, unrestricted RN license in applicable state(s) required. Multi‑state licensure is required if this individual is providing services in multiple states. Preferred Capabilities, Skills and Experiences Case Management experience is preferred. Certification as a Case Manager is preferred. Minimum 2 years’ experience in an acute‑care setting is preferred. Managed Care experience is preferred. Ability to talk and type at the same time is preferred. Demonstrate critical thinking skills when interacting with members is preferred. Experience with Microsoft Office and/or ability to learn new computer programs/systems/software quickly is preferred. Ability to manage, review and respond to emails/instant messages in a timely fashion is preferred. Salary and Benefits: For candidates working in person or virtually in California, the salary range for this position is $38.75 to $63.42 per hour. Additionally, Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all subject to eligibility requirements). The offered salary is based on legitimate, non‑discriminatory factors set by the Company. 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. #J-18808-Ljbffr Elevance Health

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