About the role
CareBridge Health, part of Elevance Health's Carelon business, is hiring a fully virtual Nurse Case Manager I based out of Grand Prairie, Texas. You'll manage care for members with complex and chronic needs, mostly by phone, with some hospital discharge planning. The schedule is Monday through Friday, 11 AM to 8 PM Central.
Responsibilities
- Manage care for members with complex and chronic needs by assessing, planning, coordinating, monitoring, and evaluating care plans
- Make sure members can reach the services their health needs require
- Assess individual needs and build a care management plan around identified goals
- Facilitate authorizations and referrals within the benefit structure or through extra-contractual arrangements
- Coordinate internal and external resources to meet members' needs
- Work with Medical Directors and Physician Advisors on treatment plans
- Negotiate reimbursement rates and help resolve provider, claims, and service issues
- Handle care telephonically or on site, for example at hospitals for discharge planning
Requirements
- Current, unrestricted RN license in the applicable state(s); multistate licensure if serving multiple states
- BA/BS in a health-related field and at least 3 years of clinical experience (or an equivalent combination)
- Must live within reasonable commuting distance of the Grand Prairie, TX office location (virtual, with required in-person training sessions)
- Schedule: Monday–Friday, 11 AM–8 PM Central
- Preferred: case manager certification, prior case management experience, and home health experience
What we offer
- Merit increases and incentive bonus programs
- Paid holidays and paid time off
- Medical, dental, and vision coverage
- Short- and long-term disability
- 401(k) with match and a stock purchase plan
- Life insurance and wellness programs