Nurse Care Mgr II
Company: Elevance Health
Location: Costa Mesa
Posted on: November 20, 2022
**Nurse Care Mgr II**
+ Job Family: Medical and Clinical
+ Type: Full time
+ Date Posted:Nov 11, 2022
+ Req #: JR35263
+ CA, Woodland Hills
+ Oregon, Oregon
+ Arizona, Arizona
+ Washington, Washington
+ Montana, Montana
+ Idaho, Idaho
+ California, California
**Title: Nurse Care Mgr II**
**Must have licensure in California.**
**Shift: Offering 8 hour/10 hour/12 hour shifts. Shift differential
**Please Note: Associates in this job are paid hourly and are
eligible for overtime.**
Responsible for collaborating with healthcare providers and/or
consumer to drive personalized health management and improve health
outcomes for optimal consumers. Performs care management activities
within the scope of licensure for members with complex and chronic
**How you will make an impact:**
+ Ensures medically appropriate, high quality, cost effective care
through assessing the medical necessity of inpatient admissions,
outpatient services, out of network services, and appropriateness
of treatment setting and level of care.
+ Partners with physician clinical reviewers and/or medical
directors to interpret appropriateness of care, intervention
planning, and general clinical guidance.
+ Collaborates with providers to assess consumer needs for early
identification of and proactive planning for discharge.
+ Conducts clinical assessment to develop goals that address
individual needs in order to develop a care plan; implements and
coordinates a care plan.
+ Monitors and evaluates effectiveness of the care management plan
and modifies as necessary.
+ Assists with development of utilization/care management policies
+ Participates in or leads intradepartmental teams, projects, and
+ Requires minimum of 3 years of acute care clinical experience,
condition specific clinical experience, home health/discharge
planning experience and a minimum of 1 year in a Nurse Care Mgr I
role or equivalent experience; or any combination of education and
experience, which would provide an equivalent background.
+ Current, unrestricted RN license in applicable state(s)
+ Multi-state licensure is required if this individual is providing
services in multiple states.
+ Case management experience is strongly preferred.
+ Strong communications skills is preferred.
+ Home health/discharge planning experience preferred.
+ AS or BS in nursing preferred.
+ Certification as a Case Manager is preferred.
For URAC accredited areas, the following applies: Current and
active RN license required in applicable state(s) that allows for
an independent assessment to be conducted within their scope of
practice. Requires 3 years full-time equivalent of direct clinical
care experience to the consumer, 5 years full-time equivalent of
direct clinical care experience to the consumer preferred or any
combination of education and experience, which would provide an
equivalent background, Multi-state licensure is required if this
individual is providing services in multiple states . Certification
as a Case Manager or a BS in a health or human services related
field, also preferred.
Please be advised that Elevance Health only accepts resumes from
agencies that have a signed agreement with Elevance Health.
Accordingly, Elevance Health is not obligated to pay referral fees
to any agency that is not a party to an agreement with Elevance
Health. Thus, any unsolicited resumes, including those submitted to
hiring managers, are deemed to be the property of Elevance
**Be part of an Extraordinary Team**
Elevance Health is a health company dedicated to improving lives
and communities - and making healthcare simpler. Previously known
as Anthem, Inc., we have evolved into a company focused on whole
health and updated our name to better reflect the direction the
company is heading.
We are looking for leaders at all levels of the organization who
are passionate about making an impact on our members and the
communities we serve. You will thrive in a complex and
collaborative environment where you take action and ownership to
solve problems and lead change. Do you want to be part of a larger
purpose and an evolving, high-performance culture that empowers you
to make an impact?
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.
The health of our associates and communities is a top priority for
Elevance Health. We require all new candidates to become vaccinated
against COVID-19. If you are not vaccinated, your offer will be
rescinded unless you provide - and Elevance Health approves - a
valid religious or medical explanation as to why you are not able
to get vaccinated that Elevance Health is able to reasonably
accommodate. Elevance Health will also follow all relevant federal,
state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in
2021, is ranked as one of the 2021 World's Most Admired Companies
among health insurers by Fortune magazine, and a Top 20 Fortune 500
Companies on Diversity and Inclusion. To learn more about our
company and apply, please visit us at careers.ElevanceHealth.com.
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
email@example.com for assistance.
EEO is the Law
Equal Opportunity Employer / Disability / Veteran
Please use the links below to review statements of protection from
discrimination under Federal law for job applicants and
+ EEO Policy Statement
+ EEO is the Law Poster
+ EEO Poster Supplement-English Version
+ Pay Transparency
+ Privacy Notice for California Residents
Elevance Health, Inc. is an E-verify Employer
Email us (firstname.lastname@example.org) or call
Keywords: Elevance Health, Costa Mesa , Nurse Care Mgr II, Healthcare , Costa Mesa, California
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