[Hiring] Remote Care Manager - RN @Elevance Health

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Remote Care Manager – RN is responsible for providing telephonic support to patients and their families. Ensures communication and coordination with all stakeholders in the home, community, with payer partners and team members. Proactively manages a census of patients, ensuring quality interactions and follow through resulting in effective clinical outcomes. • Makes outbound calls designed to build rapport/relationships and catch decline in patient status or acute issue prior to hospitalization or urgent visit need. • Identifies patients with both chronic and acute needs to ensure their care plans are intact and assists with education, goals of care and ongoing care coordination. • Identifies hospice eligibility, enters hospice orders and ensures smooth transitions of care. • Communicates with company medical director about transition to sign the order and notifies the patients primary care physician (PCP). • Contacts hospice agency to discuss case, verify receipt of order and date/time of visit. • Follows up with hospice agency daily to verify admission or failed admission. • Research failed admissions to find out why, notify team members and cancel hospice order if appropriate. • Performs clinical evaluations and patient education as requested by interdisciplinary team. • Communicates care plans to other external providers such as PCP, specialists, etc. Requests referrals to specialists. • Communicates results of tests, lab work, etc. to advanced practice provider who notifies the patient and their family of the results. • Completes documentation for durable medical equipment (DME) and documentation for Home Health which is sent to medical director for signature. • Obtains authorizations for medications that are not on the formulary medication list. Qualifications • Requires a HS diploma or equivalent and a minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. • Current valid active unrestricted RN license in applicable state(s) required. • Multi-state licensure is required if this individual is providing services in multiple states. Requirements • Experience in a centralized care management team preferred. • Prior healthcare experience serving chronically ill patients preferred. • Health plan, hospice or home health experience preferred. • Telephonic case management or care coordination experience preferred. Benefits • Market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs. • Medical, dental, vision, short and long term disability benefits. • 401(k) + match, stock purchase plan, life insurance, wellness programs and financial education resources. Apply tot his job