The Mgr I Care Mgmt is responsible for managing a team of clinicians charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources. Primary duties may include, but are not limited to:
- Assesses the medical necessity of inpatient admissions, outpatient services, out of network services, and appropriateness of treatment setting and level of care.
- Oversees process improvement, quality assurance, and adherence to applicable medical policy, care management best practices, relevant clinical standards, and member contract.
- Ensures prevention and health management program accreditation standards are achieved.
- Participates in establishing strategic plans and objectives; aligning, developing, and implementing functional area policies and procedures to support strategic plans and objectives.
- Participates in establishing and managing the annual budget productivity targets.
- Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Requirements:
- BS in Nursing and minimum of 5 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current unrestricted CA RN license in applicable state(s) required.
- Certification as a Case Manager preferred.
- Additional schooling or certifications preferred.
- NICU/HROB experience preferred.
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $102,212.00 - $127,765.00
Locations: 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.