Telephonic Nurse Case Manager II (Remote) ID-9605

February 1, 2025

Elevance Health is seeking a dedicated Telephonic Nurse Case Manager II to join our team. In this role, you will assess, develop, implement, coordinate, monitor, and evaluate care plans designed to optimize member health care across the continuum. This position is conducted primarily via telephone, offering flexibility and the opportunity to work remotely.

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Responsibilities:

Ensure members have access to services appropriate to their health needs.
Conduct assessments to identify individual needs and develop specific care management plans to address objectives and goals identified during assessments.
Implement care plans by facilitating authorizations and referrals as appropriate within the benefits structure or through extra-contractual arrangements.
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 to develop care management treatment plans.
Negotiate rates of reimbursement, as applicable.
Assist in problem-solving with providers, claims, or service issues.
Contribute to the development of utilization and care management policies and procedures.

Requirements:

Bachelor's degree in a health-related field.
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 required if providing services in multiple states.

Preferred Qualifications:

Certification as a Case Manager.
Managed care experience.
Ability to talk and type simultaneously.
Demonstrated critical thinking skills when interacting with members.
Proficiency with Microsoft Office and the ability to learn new computer programs quickly.
Experience in oncology and transplant care.
Knowledge of health insurance benefits, medical management processes, care management, and utilization review management.

Benefits:

Comprehensive benefits package, including health insurance.
Incentive and recognition programs.
Equity stock purchase options.
401(k) contributions.

Why Join Us?

At Elevance Health, we are fueled by our bold purpose to improve the health of humanity. We are transforming from a traditional health benefits organization into a lifetime trusted health partner. Our nearly 100,000 associates serve more than 118 million people at every stage of health. We address a full range of needs with an integrated whole health approach, powered by industry-leading capabilities and a digital platform for health. We believe that improving health for everyone is possible. It begins by redefining health, reimagining the health system, and strengthening our communities.

How to Apply:

If you meet the qualifications and are passionate about making a difference in healthcare, we encourage you to apply. Please submit your application through our careers portal. Qualified candidates will be contacted via email with instructions on completing an online pre-employment skills assessment, which must be completed within 48 hours of receipt.

Telephonic Nurse Case Manager II (Remote) ID-9605

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

DISCLAIMER

Other Jobs You May Be Interested In

Telephonic Nurse Case Manager II (Remote) ID-9605

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

5. HOW DO YOU PROCESS INFORMATION?

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

8. HOW TO PRIORITIZE WORK?

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

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