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Telephonic Nurse Case Manager II

Medical DirectorMedical DirectorFull TimeRemoteLeadTeam 10,001+H1B SponsorCompany SiteLinkedIn

Location

Washington + 7 moreAll locations: Washington | Colorado | California | Nevada | Texas | Georgia | Florida | Canada

Posted

89 days ago

Salary

$79.5K - $130K / year

Seniority

Lead

Bachelor Degree

Job Description

Telephonic Nurse Case Manager II

Elevance Health

Anticipated End Date: 2026-03-25 Position Title: Telephonic Nurse Case Manager II Job Description: Telephonic Nurse Case Manager II Sign on Bonus: $2000. Location: Virtual: 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. Preferred locations: Seattle, WA, Denver, CO, Costa Mesa, CA or Las Vegas, NV. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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 9:00am to 5:30pm with 1-2 late evenings 11:30am to 8:00pm depending on your time zone. *****This position will service members in different states; therefore, Multi-State Licensure will be required. The Telephonic 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(s) required. - Multi-state licensure is required if this individual is providing services in multiple states. Preferred Capabilities, Skills and Experiences: - Case Management experience is preferred. - Certification as a Case Manager is preferred. - Minimum 2 years’ experience in acute care setting is preferred. - Managed Care experience is preferred. - California RN license is a plus. - Ability to talk and type at the same time is preferred. - Demonstrate critical thinking skills when interacting with members is preferred. - Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly is preferred. - Ability to manage, review and respond to emails/instant messages in a timely fashion is preferred. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $79,464 to $130,548. Locations: Colorado; Nevada; Washington State; California. 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, consistent with the law. Job Level: Non-Management Exempt Workshift: 1st 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.

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Medical Director89 days ago
Full TimeRemoteTeam 10,001+H1B Sponsor

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United States
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Dexcom logo

Medical Science Liaison Manager (Remote)

Dexcom

Empowering people to take control of health

Medical Director89 days ago
Full TimeRemoteTeam 10,001+Since 1999H1B Sponsor

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United States
$122K - $204K / year
Job Closed
Wellbe Senior Medical logo

Mostly Remote-Community Medical Director-Physician-Must live Near Chicago

Wellbe Senior Medical

WellBe is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected status.

Medical Director89 days ago
Full TimeRemoteTeam 501-1,000

Job Summary About Us: Come reimagine care with us! We’re on a mission to change the way medical care is delivered around the country. By supplying home-based medical care to patients who need it most, WellBe is changing lives by providing care wherever our patients call home. WellBe’s primary care services are delivered by a team of licensed clinicians in the comfort of the patient’s home. By combining the strength of physicians, nurse practitioners, social workers, paramedics, and other healthcare professionals, WellBe delivers an extra level of support to the patients we serve in their communities. This high-risk population is typically underserved and challenged with access to care which we provide. To address these problems, we have elected to bring the care to the patient, instead of trying to bring the patient to the care. WellBe’s clinician-led geriatric care teams provide concierge-level medical care and social support in the home as well as delivering and coordinating across the entire care continuum – from chronic care and urgent care in the home to hospital to skilled nursing facility to assisted living to palliative care, to end-of-life care. Joining WellBe means joining a growing, purpose-driven organization to deliver the highest quality care to our senior communities and to make an impact on lives every day. Why WellBe? WellBe’s Culture is Welcoming - Be part of something important: - Be part of pioneering a new way of healthcare that is revolutionizing the industry. - A patient-focused environment that ensures patients can live a fulfilling life whatever their health level is. Our focus is to give our patients more good days. - Give yourself incredible opportunities: - Growth and development opportunities across expanding markets in the company and celebrate success on a global scale. - Training in the WellBe model and team-based care. Full in-person orientation, vision, mission, and values introduction, and instilling cultural ideals. Respect and trust for how you work and how you make a difference. - Work as part of a collaborative team with a strong team culture. - You own your role, contribute to the team, and feel the enormous impact on lives. - Leadership that listens, trusts, empowers, and supports. - Empowerment and ownership for solving problems that arise and doing the right thing in each interaction. - Pioneering a new way of healthcare that is revolutionizing the industry. What we offer: - Full-time permanent, work seeing patients in their home, traveling around to other home locations. Work during the daytime, flexible schedule, and on-call rotation. - Rich and competitive total rewards package including health benefits, dental, vision, life insurance, dependent care reimbursement, STD/LTD, 401k match with immediate vesting, paid time off / floating holidays, commuter/transportation (mileage) reimbursement, and educational reimbursement. - The opportunity to work with a progressive company, who is making a difference each day with every patient. About the Position:Our Community Medical Directors oversee the clinical” Community Team” dedicated to a patient community population. Community Medical Director will be expected to manage, mentor, and guide the clinical “Community Team” as well as deliver primary, urgent, and acute medical care to an assigned population of patients. A successful candidate will collaborate with various clinicians along with administrative/operational team(s) to deliver exceptional clinical, operational outcomes to WellBe patients and their families. The Community Medical Director will be a WellBe Ambassador responsible for working with community physicians, hospitals, and other medical facilities including SNF's. Community Medical Director at WellBe will be expected to contribute to our culture of collaboration, innovation, significant impact to the lives of our patients while experiencing personal growth within the organization. Safety-Sensitive Statement:This position has been designated as safety-sensitive. As such, the employee must be able to perform job duties in a manner that ensures the safety of themselves, coworkers, patients, and the public. The role requires full cognitive and physical functioning at all times. Employees in safety-sensitive positions are subject to drug and alcohol testing, including for substances that may impair judgment or motor function, in accordance with applicable federal and state laws and company policy. Due to the safety-sensitive nature of this role and in alignment with federal law and workplace safety standards, the use of marijuana—including medical or recreational use—is prohibited. WellBe Senior Medicalwill comply with applicable state laws regarding medical marijuana and reasonable accommodations, where such laws do not conflict with safety requirements or federal regulations. Drug Screening Requirement:As a condition of employment, WellBe Senior Medical requires all candidates to successfully complete a pre-employment drug screening. Ongoing employment may also be contingent upon compliance with the company’s Drug-Free Workplace Policy, which includes random, post-accident, and reasonable suspicion drug testing. The company reserves the right to test for substances that may impair an employee’s ability to safely and effectively perform their job duties. Americans with Disabilities Act:WellBe Senior Medical is committed to complying with the Americans with Disabilities Act (ADA) and applicable state and local laws. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job. If you require an accommodation during the application or employment process, please contact Human Resources at HRPeopleLine@wellbe.com Job Description WellBe Community Medical Director – What to Expect: - Practices the WellBe mission: To help our patients lead healthier, meaningful lives by delivering the most Complete Care. - Collaborates with a clinical “Community Team” consisting of interdisciplinary team in managing the health and wellbeing of patients living in their homes. - Has a successful relationship with the Market GM, and Senior Medical Officer to achieve quality outcomes and growth in the community. - Understanding the impact on local and national landscape involving the WellBe clinical model consisting of: Health Policy, Socioeconomics, competition, CMS, regulatory, and other clinical data relevant to quality patient care. - Prioritizes and acts on the most promising opportunities to improve outcomes/performance of the Community metrics (i.e. clinical, cost/revenue, partnerships, and quality measures). - Spends time fostering key relationships in the Community Network - For Hospitals and SNFs, where WellBe is not the attending, Community Medical Director will identify Hospitalists and SNFist groups, build individual relationships where mutual patient outcomes are achieved and creating contractual relationships when additional alignment is needed - Partner with WellBe Leadership to grow the organization, innovate the model and improve execution - Develops constructive Cross-functional / Matrix Relationships with WellBe business partners to enable the model. - Community Medical Director will be responsible for floating within the community physician role as needed - Other tasks needed to accomplish team’s objectives/goals Job Requirements Must Haves: Educational/Experience Requirements: - Doctor of Medicine (MD) or Doctor of Osteopathy (DO) - Current and valid state medical license required - 5+ years’ experience managing an interdisciplinary team - 5+ years’ minimum experience as a community physician preferred mostly geriatric care. - 3+ years’ responsibility for managing a P&L Required Skills and Abilities: - Geriatric certified preferred - Palliative care certified/focus preferred - Basic Life Support (BLS) certified - Have a valid driver’s license, have access to a car and willingness to drive to patient homes/patient location as well as an active auto insurance policy - EHR medical documentation experience - Strong computer skills, including Word, Excel, and PowerPoint - Strong verbal, written, presentation, and interpersonal communication skills - Excellent bedside manner and time management skills Supervisory Responsibility: This position will have direct management authority. Travel Requirements: Travel may be required up to 70% locally. Work Conditions: Ability to lift up to 20lbs. Moving lifting or transferring of patients may involve lifting of up to 50lbs as well as assist with weights of more than 100lbs. Ability to stand for extended periods. Ability to drive to patient locations (ie. home, hospital, SNF, etc). Fine motor skills/visual acuity WellBe Senior Medical is an equal opportunity employer. We embrace diversity, inclusion, and equity and encourage all interested readers to apply at wellbeseniormedical.com/careers. The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change, or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role. Zip Code- 60606 Job: Clinical—Medical Doctor MD, Doctor of Osteopath DO, Regular Physician Shift. Full Time Job Level: Day Job, 8am, 5pm, Travel, Monday, Friday. No evening, no weekend hours unless desired. Job, Clinical, Nursing, Regular, Job Type, Physician Standard, Pay, Hours. Geriatric population

United States
Job Closed