Telephonic Transplant Nurse Case Manager II

Anticipated End Date :

Position Title :

Telephonic Transplant Nurse Case Manager II

Job Description :

Telephonic Transplant Nurse Case Manager II

Location : This role enables associates to work virtually full-time with the exception of required in-person training sessions providing maximum flexibility and autonomy. This approach promotes productivity supports work-life integration and ensures essential face-to-face onboarding and skill development.

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 8 : 00am to 4 : 30pm EST.

• This position will service members in different states; therefore Multi-State Licensure will be required.

The Telephonic Transplant 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 :

Transplant experience.

Case Management experience.

Certification as a Case Manager.

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 virtually in the below locations the salary

Locations : New York

In 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.

Job Level :

Non-Management Exempt

Workshift : Job Family :

MED >

Licensed Nurse

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 Are

Elevance 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 Work

At 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.

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 and Influenza. 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 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.

Required Experience :

Manager

Key Skills

Project Portfolio Management,Motivational Interviewing,HIPAA,Computer Skills,Intake Experience,Lean Six Sigma,Conflict Management,Case Management,Team Management,Program Development,Social Work,Addiction Counseling

Employment Type : Full-Time

Experience : years

Vacancy : 1

Monthly Salary Salary : 76944 - 115416