Nurse Case Mgr Sr (CA)-1 at Elevance Health

The Telephonic Nurse Case Manager Sr. is responsible for care management for members with complex and chronic needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. This includes ensuring member access to services, conducting assessments, implementing care plans by facilitating authorizations and referrals, coordinating resources, monitoring plan effectiveness, and interfacing with Medical Directors. The role may involve negotiating reimbursement rates, assisting with provider/claims issues, developing policies, chairing meetings, presenting cases, and potentially serving as a preceptor for new staff while participating in audit activities.