Anticipated End Date: 2026-03-14 Position Title: Triage RN - Virtual - Overnight - CareBridge Job Description: Work Location: Virtual This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), 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. Seeking candidates who have an active, unrestricted RN Compact license or Multi-state RN licenses in either of the following states: AZ, FL, IA, IN, KS, MA, NM, OH, TN, TX, NJ, HI or VA. Carebridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. Carebridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services Work Shift - Overnight: 10pm - 8am (Central Standard Time) The RN will work eight (8)10-hour work shifts, in a two-week period which includes Saturday and Sunday every other weekend. The Triage Nurse I - Overnight - CareBridge is responsible for determining the appropriate Care Management program for members referred through internal and external sources and various data sources and reports. Utilizing department guidelines, completes triage process and applies established criteria to assign members to appropriate care management component. Deals with least complex cases having limited or no previous Triage care experience. Primary duties may include but are not limited to: - Utilizes the nursing process to meet an individual’s health needs, utilizing plan benefits and community resources. - Educates members about contracted physicians, facilities and healthcare providers. - Learn to develop favorable working partnerships and collaborative relationships with members, physicians, healthcare service providers, and internal and external customers to help improve health outcomes for members. - Works in collaboration with medical management and care management associates to identify issues, problems, and resource needs and assign to appropriate care management program. - Facilitates selecting appropriate candidates for referral to CM and/or DM. - Partners with social work as appropriate. - Identifies and refers cases or issues to QI, SIU, Subrogation, Underwriting, or other departments as appropriate. - Documents appropriate clinical information, decisions, and determinations in a timely, accurate, and concise manner. - Develops a working knowledge of member benefits, contracts, medical policy, professional standards of practice, and current health care practices. Position requirements: - Requires AS in nursing and minimum of 2 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background. - Current unrestricted RN license in the applicable state(s) required. Preferred qualifications, skills, and experiences: - Current, active, RN Compact license highly preferred. - Emergency Room and/or Urgent Care experience highly preferred. - Telehealth experience. - Experience with EMR systems. - BS in nursing preferred. - Participation and/or certification in a managed care or utilization management organization preferred. - Ability to understand clinical information and prepare a concise summary following department standards strongly preferred. - Basic knowledge of the medical management and care management process and role preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $67,200 to $115,920 Locations: Cleveland, OH; Columbus, OH; Massachusetts; New Jersey, Hawaii 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. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, Job Level: Non-Management Exempt Workshift: 3rd Shift (United States of America) 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 elevancehealthjobssupport@elevancehealth.com 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. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Become a part of our caring community and help us put health first The Care Coach is responsible for evaluating members’ needs and requirements to help them achieve and maintain optimal wellness. This is accomplished by guiding members and their families toward, and facilitating interaction with, resources that are appropriate for the care and wellbeing of members. The Care Coach 1 position involves work assignments that are typically straightforward and of moderate complexity. The following section outlines the specific duties and responsibilities associated with the Care Coach 1 role. This position, which reports to the Manager of Care Management within Humana Healthy Horizons in Virginia, is focused on supporting members and their families in accessing the resources needed to promote their overall health and wellness. In this role you will: - Manages a caseload of members. - Develops and modify Individual Care Plan and involve applicable members of the care team in care planning (Informal caregiver, coach, PCP, etc.). - Provides specialized support for members with a focus on addressing health related social needs (HRSNs), providing psychosocial support, and meeting the member's individualized health needs. - Ensures members are receiving services in the least restrictive setting to achieve and/or maintain optimal well-being by assessing their care needs. - Focuses on supporting members and/or caregivers utilizing an interdisciplinary approach in accessing social, housing, educational and other services, regardless of funding sources to meet their needs. - Ensures members are progressing towards desired outcomes by continuously monitoring patient care through use of assessment, data, conversations with member, and active care planning. - Collaborates with Community Health Workers (CHWs), Housing Specialists and other internal and external agencies for HRSN needs. - Primary point of contact for the ICT and shall be responsible for coordinating with the member, ICT participants, and outside resources to ensure the member’s needs are met. - Employs a variety of strategies, approaches and techniques to manage a member's health issues and identify and resolve barriers that hinder effective care. - Understands professional concepts, regulations, strategies and operating standards. - Makes decisions regarding work approach/priorities and follows direction. Use your skills to make an impact Required Qualifications - Must reside in Virginia (NOVA region) - Bachelor's degree in health or human services field or an active LPN license in the Commonwealth of Virginia without disciplinary action. - Two (2) years of prior experience in health care and/or case management. - One (1) year of experience working directly with individuals who meet the Cardinal Care Priority Population criteria (adults, pediatrics populations at risk for chronic medical conditions & high social needs). - Intermediate to advanced computer skills and experience with Microsoft Word, Excel, and Outlook. - Ability to use a variety of electronic information applications/software programs including electronic medical records. (Patient Information, Patient documentation) - Exceptional oral and written communication and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders. - Ability to manage multiple or competing priorities in a fast-paced environment. Preferred Qualifications - Prior experience with Medicare, Medicaid and dual eligible populations. - Experience with health promotion, coaching and wellness - Knowledge of community health and social service agencies and additional community resources - Bilingual or Multilingual: English/Spanish, Arabic, Vietnamese, Amharic, Urdu or other - Must be able to speak, read and write in both languages without limitations and assistance. See "Additional Information" section for more information. Additional Information Workstyle: Field - This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes. Workdays and Hours: Must be able to work a 40 hour work week, Monday through Friday 8:00 AM to 5:00 PM, over-time may be requested to meet business needs and requires approval. Screening: This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB. Travel, Driver's License, Transportation, Insurance: Must be willing to travel at least 30-50% of the time within your assigned Region where you reside in Northern Virginia, to conduct field visits with members in your assigned area. Travel requirements may vary based on member tier level. May need to attend onsite meetings occasionally in Humana Healthy Horizons office in Glen Allen, VA. Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Humana's Driver Safety Program This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. - Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher. Mileage reimbursement is provided for work-related travel. Eligible mileage includes: - Travel from your home to your first work location of the day. - Travel between client or assignment locations during the workday. - Travel from your final work location back to your home. Work at Home Guidance To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is required. - Satellite, cellular and microwave connection can be used only if approved by leadership. - Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,700 - $72,600 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. ​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. - Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal - Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards - Communicates with members, providers, facilities, and other departments regarding appeals requests - Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards - Works with leadership to increase the consistency, efficiency, and appropriateness of responses of all appeals requests - Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices - Performs other duties as assigned - Complies with all policies and standards Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience. Knowledge of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. License/Certification: - LPN - Licensed Practical Nurse - State Licensure required or - LVN - Licensed Vocational Nurse required or - RN - Registered Nurse - State Licensure and/or Compact State Licensure required or - LCSW- License Clinical Social Worker required or - LMHC-Licensed Mental Health Counselor required or - LPC-Licensed Professional Counselor required or - Licensed Marital and Family Therapist (LMFT) required or - Licensed Psychologist required - For Health Net of California: RN license required Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. - Prepares case reviews for Medical Directors by researching the appeal, reviewing applicable criteria, and analyzing the basis for the appeal - Ensures timely review, processing, and response to appeal in accordance with State, Federal and NCQA standards - Communicates with members, providers, facilities, and other departments regarding appeals requests - Generates appropriate appeals resolution communication and reporting for the member and provider in accordance with company policies, State, Federal and NCQA standards - Works with leadership to increase the consistency, efficiency, and appropriateness of responses of all appeals requests - Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices - Performs other duties as assigned - Complies with all policies and standards This is a fully remote position. Candidates with an active RN license and utilization management experience are highly preferred. Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience. Knowledge of NCQA, Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. License/Certification: - LPN - Licensed Practical Nurse - State Licensure required or - LVN - Licensed Vocational Nurse required or - RN - Registered Nurse - State Licensure and/or Compact State Licensure required or - LCSW- License Clinical Social Worker required or - LMHC-Licensed Mental Health Counselor required or - LPC-Licensed Professional Counselor required or - Licensed Marital and Family Therapist (LMFT) required or - Licensed Psychologist required Pay Range: $27.02 - $48.55 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act