Elevance Health

Nurse Case Mgr II (US)

Elevance Health · Full Time · 4 hours ago

Elevance Health

🌎 United States 💵 $79464 - $130K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Telephonic Nurse Case Manager II assesses, develops, and monitors care plans for members with complex and chronic health needs. They coordinate internal and external resources while interfacing with medical directors to optimize member healthcare outcomes.

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CareBridge Advance Practice Provider, Nurse Practitioner  

Elevance Health · Full Time · 4 hours ago

Elevance Health

🌎 United States 💵 $110K - $198K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Nurse Practitioner collaborates with physicians and interdisciplinary teams to develop and implement complex clinical care plans for patients in home and community-based settings. They provide primary and urgent care via telephone and video modalities while maintaining accurate medical documentation and coordinating resources for patients and their families.

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CareBridge Advance Practice Provider, Nurse Practitioner

Elevance Health · Full Time · 4 hours ago

Elevance Health

🌎 United States 💵 $110K - $165K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Nurse Practitioner collaborates with physicians and interdisciplinary teams to develop and implement complex clinical care plans for patients in home and community-based settings. They provide primary and urgent care via telehealth, manage chronic conditions, and educate patients and families on health maintenance and medication adherence.

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CareBridge Advance Practice Provider, Nurse Practitioner  

Elevance Health · Full Time · 4 hours ago

Elevance Health

🌎 United States 💵 $110K - $189K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Nurse Practitioner collaborates with physicians and interdisciplinary teams to develop and implement complex clinical care plans for patients in home and community-based settings. They provide primary and urgent care via telephone and video modalities while educating patients and families on health management and medication adherence.

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CareBridge Advance Practice Provider, Nurse Practitioner - Bilingual

Elevance Health · Full Time · 4 hours ago

Elevance Health

🌎 United States 💵 $110K - $198K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Nurse Practitioner collaborates with physicians and interdisciplinary teams to develop and implement complex clinical care plans for patients in home and community-based settings. They provide primary and urgent care via telephone and video modalities while educating patients and families on health management and medication adherence.

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CareBridge Advance Practice Provider, Nurse Practitioner - Bilingual

Elevance Health · Full Time · 4 hours ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The Nurse Practitioner collaborates with physicians and interdisciplinary teams to develop and implement complex clinical care plans for patients in home and community-based settings. They provide primary and urgent care via telephone and video modalities while educating patients and families on health management and coordinating care resources.

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CareBridge Advance Practice Provider, Nurse Practitioner  

Elevance Health · Full Time · 5 hours ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The Nurse Practitioner collaborates with physicians and families to develop and implement complex clinical care plans for patients in home and community-based settings. They provide primary and urgent care via telehealth, identify gaps in care, and educate patients on medication and health management.

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Pharmacy Technician II - CarelonRx

Elevance Health · Full Time · 7 hours ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The Pharmacy Technician II is responsible for interpreting and entering moderately complex prescriptions, processing prior authorizations, and troubleshooting adjudication issues. They also provide support by resolving grievances, educating members on medication adherence, and coordinating with providers to close care gaps.

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Nurse Practitioner 100% Virtual, CareBridge

Elevance Health · Full Time · 7 hours ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The Nurse Practitioner collaborates with physicians and interdisciplinary teams to develop and implement complex care plans for patients with chronic conditions. They provide urgent healthcare via telephone and video modalities while maintaining accurate medical records and educating families on health management.

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Reviewer - Therapy Services - Commercial

Elevance Health · Full Time · 7 hours ago

Elevance Health

🌎 United States 💵 $29.16 - $52.96 per hour ⭐ 0-2 yrs exp 💼 Others

The Reviewer evaluates medical records to determine the medical necessity of therapy service requests and processes authorization decisions. They also document findings, analyze data, and submit reports in accordance with government regulations and operational goals.

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Outreach Care Specialist I

Elevance Health · Full Time · 10 hours ago

Elevance Health

🌎 United States ⭐ 0-2 yrs exp 💼 Others

The Outreach Care Specialist I manages clinical referrals and coordinates follow-up care plans to ensure member compliance with treatment. They also identify health risks, support HEDIS/Star program goals, and facilitate referrals to community-based programs.

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LPN/LVN 100% Virtual, CareBridge

Elevance Health · Full Time · 10 hours ago

Elevance Health

🌎 United States 💵 $22.3 - $32.06 per hour ⭐ 2-5 yrs exp 💼 Healthcare

The LPN/LVN is responsible for examining and treating patients under physician direction, including reviewing medical records and recording vital signs. They provide nursing interventions and coaching while facilitating patient transfers to alternate levels of care.

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Outreach Care Specialist

Elevance Health · Full Time · a day ago

Elevance Health

🌎 United States 💵 $18.46 - $33.5 per hour ⭐ 0-2 yrs exp 💼 Others

The Outreach Care Specialist coordinates follow-up care plans and assesses member compliance with medical treatment via telephone or on-site visits. They identify barriers to care, recommend process improvements, and coach members on reducing health risks.

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Nurse Case Manager I

Elevance Health · Full Time · a day ago

Elevance Health

🌎 Canada, United States 💵 $70560 - $110K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Nurse Case Manager performs telephonic care management for members with complex and chronic needs by assessing, developing, and monitoring individualized care plans. They coordinate internal and external resources while interfacing with Medical Directors to optimize member health outcomes.

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Coding Analyst Sr.

Elevance Health · Full Time · a day ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Others

The Coding Analyst Sr. is responsible for auditing and coding medical records to ensure accurate reimbursement, compliance, and documentation. They also provide training and education to staff while serving as a resource for complex coding and billing issues.

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Coding Auditor Sr. (CareBridge)

Elevance Health · Full Time · a day ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Finance

The Coding Auditor Sr. is responsible for auditing diagnosis data from medical records to ensure ICD-9 coding accuracy and compliance with risk adjustment requirements. They also serve as a subject matter expert, participate in leadership groups, and identify training opportunities.

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Crisis & Referral Specialist- LA

Elevance Health · Full Time · a day ago

Elevance Health

🌎 United States ⭐ 0-2 yrs exp 💼 Others

The Crisis & Referral Specialist performs safety screenings and telephonic interventions for individuals in crisis to determine appropriate courses of action. They also coordinate with external agencies and organizations to ensure callers access necessary resources and support services.

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Nurse Practitioner 100% Virtual, CareBridge

Elevance Health · Full Time · a day ago

Elevance Health

🌎 United States 💵 $104K - $189K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Nurse Practitioner collaborates with physicians and interdisciplinary teams to develop and implement complex clinical care plans for patients in home and community-based settings. They provide urgent care via telehealth modalities and educate patients and families on medication, health maintenance, and crisis prevention.

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Inpatient DRG Validator (Acute Care)

Elevance Health · Full Time · 3 days ago

Elevance Health

🌎 United States 💵 $95172 - $149K per year ⭐ 5-10 yrs exp 💼 Others

The Inpatient DRG Validator audits medical records to ensure accurate coding and DRG assignment while identifying recoverable claims. They also analyze clinical documentation to substantiate audit findings and suggest process improvements.

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Behavioral Health Care Manager II - ABA - GA/NC

Elevance Health · Full Time · 4 days ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The Behavioral Health Care Manager II manages ABA pre-certification health benefits through telephonic or written review using clinical judgment. They also assist with complex cases and serve as a resource to other care managers to ensure quality member outcomes.

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Behavioral Health Case Manager II

Elevance Health · Full Time · 4 days ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The Behavioral Health Case Manager II performs telephonic and in-person case management for members with behavioral health and substance abuse needs. They assess member needs, develop and monitor care plans, and collaborate with internal and external resources to ensure quality, cost-effective care.

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Clinical Review Nurse I/II/Sr/Lead

Elevance Health · Full Time · 5 days ago

Elevance Health

🌎 United States 💵 $79760 - $114K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Clinical Review Nurse Senior coordinates and oversees the work of clinical nurse reviewers and non-clinical support teams. They are responsible for responding to complex medical issues and serving as a departmental liaison to other business areas.

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Advanced Therapy Services Reviewer (Physical Therapist)

Elevance Health · Full Time · 6 days ago

Elevance Health

🌎 United States ⭐ 0-2 yrs exp 💼 Healthcare

The reviewer conducts clinical case evaluations to determine the medical necessity of therapy services and ensures consistent, compliant decision-making. They also lead peer-to-peer calls with providers and document findings in accordance with regulatory standards.

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Advanced Practice Provider, Acute (Nurse Practitioner) - Virtual

Elevance Health · Full Time · 6 days ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The Advanced Practice Provider develops and implements complex care plans for patients via telephone and tele-video modalities. They coordinate with interdisciplinary teams and physicians to ensure optimal care, patient education, and accurate medical documentation.

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Triage RN I - Virtual - CareBridge

Elevance Health · Full Time · 6 days ago

Elevance Health

🌎 United States 💵 $67200 - $115K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Triage Nurse determines appropriate care management programs for members by applying established clinical guidelines and criteria. They facilitate referrals, educate members on healthcare resources, and maintain accurate clinical documentation.

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Therapy Services Specialist (Bilingual Spanish)

Elevance Health · Full Time · 7 days ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Others

The Therapy Services Specialist performs telephonic and virtual assessments to identify participant needs and provides recommendations for supportive services. They also educate participants on home modifications and assistive technology while collaborating with the clinical team to document member encounters.

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Primary Care Nurse Practitioner, 100% Virtual

Elevance Health · Full Time · 7 days ago

Elevance Health

🌎 United States 💵 $110K - $165K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Nurse Practitioner will provide primary and acute care via telehealth to patients in home and community-based settings. They are responsible for developing and implementing complex clinical care plans while coordinating with interdisciplinary teams and family members.

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Behavioral Health Case Manager I

Elevance Health · Full Time · 7 days ago

Elevance Health

🌎 United States 💵 $61028 - $96360 per year ⭐ 2-5 yrs exp 💼 Healthcare

The Behavioral Health Case Manager performs telephonic and field-based case management to assess member needs and develop effective care plans. They monitor the effectiveness of these plans while coordinating with internal and external resources to ensure quality, cost-effective care.

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Clinical Review Nurse Senior (US)

Elevance Health · Full Time · 8 days ago

Elevance Health

🌎 United States 💵 $79760 - $114K per year ⭐ 5-10 yrs exp 💼 Healthcare

Coordinates and oversees the work of clinical nurse reviewers and non-clinical support teams. Handles complex medical issues and serves as a departmental liaison for process improvement initiatives.

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Billing Specialist Senior

Elevance Health · Full Time · 8 days ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Finance

The Billing Specialist Senior is responsible for maintaining the billing system database and reconciling data discrepancies. They provide billing information to internal and external contacts and handle complex billing situations with minimal guidance.

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Primary Care Nurse Practitioner, 100% Virtual

Elevance Health · Full Time · 11 days ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Collaborate with physicians and families to develop complex care plans for adult patients with chronic conditions via telephone and video modalities. Provide clinical support, manage medication, and coordinate resources to maximize patient health and independence.

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Outreach Care Specialist II (US)

Elevance Health · Full Time · 11 days ago

Elevance Health

🌎 United States 💵 $24.06 - $30.07 per hour ⭐ 2-5 yrs exp 💼 Others

The specialist ensures member treatment plans are followed for moderately complex cases and identifies ways to improve member health. Key duties include coordinating follow-up care, assessing compliance via phone or site visits, and coaching members to reduce health risks.

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Outreach Care Specialist

Elevance Health · Full Time · 12 days ago

Elevance Health

🌎 United States 💵 $22.34 - $25.1 per hour ⭐ 0-2 yrs exp 💼 Others

The specialist ensures member treatment plans are followed for less complex cases and identifies ways to improve member health. Key duties include scheduling follow-up care, assessing compliance via phone or site visits, and coordinating referrals to funded programs.

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Nurse Case Manager 1 100% Virtual, Carebridge

Elevance Health · Full Time · 12 days ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Responsible for performing care management for members with complex and chronic needs by assessing, implementing, and monitoring personalized care plans. This includes coordinating internal and external resources and interfacing with Medical Directors to optimize member health outcomes.

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Psychologist Reviewer - ABA

Elevance Health · Full Time · 14 days ago

Elevance Health

🌎 United States 💵 $93120 - $160K per year ⭐ 2-5 yrs exp 💼 Healthcare

Collaborate with providers and Medical Directors to determine the appropriateness of care levels based on Medical Necessity Criteria, primarily for ABA services. Conduct pre-certification, concurrent reviews, and appeals while mentoring Behavioral Health Care Management staff.

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Psychologist Reviewer Senior - ABA

Elevance Health · Full Time · 14 days ago

Elevance Health

🌎 Canada, United States 💵 $107K - $185K per year ⭐ 5-10 yrs exp 💼 Healthcare

Provides clinical guidance and leadership for behavioral health psychology services, focusing on the clinical integrity of ABA and psychological testing programs. Collaborates with providers and Medical Directors to determine appropriate levels of care based on medical necessity criteria.

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PBM Billing Specialist Senior

Elevance Health · Full Time · 15 days ago

Elevance Health

🌎 United States 💵 $19.22 - $34.9 per hour ⭐ 2-5 yrs exp 💼 Finance

The role involves assembling and maintaining billing documentation and managing the billing system database. Key tasks include reconciling data discrepancies, posting to sub ledgers, and coordinating account eligibility with internal and external contacts.

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Bilingual Nurse Practitioner 100% Virtual, CareBridge

Elevance Health · Full Time · 18 days ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Collaborate with providers and families to develop complex care plans for adult patients with chronic conditions via telephone and video. Provide urgent healthcare support, manage medical documentation, and coordinate resources to maximize patient independence and quality of life.

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Pharmacy Technician II – Clinical Pharmacy Care Center

Elevance Health · Full Time · 19 days ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Responsible for interpreting and entering moderately complex prescriptions and processing prior authorizations for Medicare, Medicaid, and Commercial members. The role involves educating members on medication adherence and coordinating with providers to close care gaps.

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Pharmacy Technician II

Elevance Health · Full Time · 19 days ago

Elevance Health

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The role involves verifying member information, educating patients on medication adherence and resources, and coordinating preventive screenings. The technician performs outreach to members and providers to close care gaps and improve health outcomes.

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Associate Medical Director - Outpatient Rehab

Elevance Health · Full Time · 25 days ago

Elevance Health

🌎 United States 💵 $188K - $294K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Associate Medical Director supports medical management staff by ensuring timely and consistent medical necessity decisions for members and providers. Responsibilities include conducting clinical case reviews, handling grievances and appeals, and performing physician-to-physician calls.

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BH Care Manager I (US)

Elevance Health · Full Time · 9 months ago

Elevance Health

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

The Behavioral Health Care Manager I conducts utilization management reviews for mental health and substance use disorder benefits. This includes assessing member needs and coordinating care to promote quality outcomes and effective use of health benefits.

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Behavioral Health Care Manager II

Elevance Health · Full Time · 10 months ago

Elevance Health

🌎 United States 💵 $82080 - $123K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Behavioral Health Care Manager II is responsible for managing psychiatric and substance abuse treatment through telephonic or written review. This role involves assessing member needs, coordinating care, and promoting effective use of health benefits.

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