Job ID: JP00045694
Anticipated Start Date: 7/21/2025
Please note this is the target date and is subject to change. Mindlance will send official notice ahead of a confirmed start date.
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 care needs.
Primary duties may include, but are not limited to:
- Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions and extensions of stay, 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 and implement a care plan.
- Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
- Familiarity with HEDIS and quality performance metrics preferred
- Ability to effectively reach doctor’s offices staff and providers to address patient/member needs
Requirements:
- Requires a HS diploma or equivalent and a minimum of 3 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current, active valid unrestricted RN license in applicable state(s) required.
- Multi-state licensure is required if this individual is providing services in multiple states.
- 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.
Job Type: Contract
Additional Details:
- Schedule: Monday – Friday, 9:00am – 5:00pm (with flexibility to support different time zones as needed)
- Hybrid (1 day weekly/ day of your choice) however, we offer flexibility and are open to a remote arrangement
- This role will consist of guiding patients through their healthcare journey, including coordinating care across multiple services and specialties, educating patients and their families, etc.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, contractors are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
About Mindlance:
Founded in 1999, Mindlance is a certified diversity business and has been on the Staffing Industry Analysts list of Fastest-Growing US Staffing Firms twelve times. As a top-performing partner to leading workforce programs, Mindlance is known for delivering consistently high-quality tech first talent solutions. Our strong processes help clients build agile and diverse workforces, while creating an ease of onboarding and service to our consultants.
Mindlance provides specialized staffing solutions across the Healthcare industry and associated skill domains. Headquartered in Union, NJ with presence in over 40 key locations across US, Canada and India, servicing 200+ global clients and 5000+ consultants. Our services include Direct Sourcing, Global EoR & AoR, Payroll, Returnship, and Recruit-Train-Deploy solutions. With over $400 million in annual revenue, our success is rooted in a mindful commitment to balance in work, from which our name is derived.
Mindlance is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.
To learn more about how Mindlance collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. Mindlance will only use this information to complete the recruitment process.
This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.
Benefits Information
Mindlance offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.
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. This does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.).