Remote Care Manager - RN

Anticipated End Date:

2025-12-24

Position Title:

Remote Care Manager - RN

Job Description:

Shift: Option of 5 8-hour shifts OR 4 10-hour shifts per week

Location: Candidates in Texas, Tennessee, and Kansas preferred; PST, MST, CST time zones preferred

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.

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 

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.

How you will make an impact:

• 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.

Minimum requirements:

• 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.

Preferred skills, capabilities, and experiences:

• 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.

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