Nurse Case Mgr II

The Nurse Case Manager II is responsible for performing care management for members with complex and chronic care needs. This role is ideal for those who excel in assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize member health care.

• Pay: $79,464 - $119,196/year
• Location: Latham, NY
• Schedule: Full-time, M-F 8am-4:30pm with 2-3 late evenings a month

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify individual needs and develop care management plans.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the effectiveness of care management plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem solving with providers, claims, or service issues.
• Assist with the development of utilization/care management policies and procedures.

• Education: BA/BS in a health-related field required
• Experience: Minimum of 5 years of clinical experience required
• Licenses &
  
  Certifications:
  
  
• Current, unrestricted RN license in applicable state(s) required
• Multi-state licensure required if providing services in multiple states
• Certification as a Case Manager preferred

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. They are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels who are passionate about making an impact on their members and the communities they serve.