Top 30 Nurse case managers Jobs in Guaynabo, Pr

Nurse Care Manager I (NCLEX)
Elevance Health —San Juan, PR
- 8 hour shift
- Nursing
- RN License
- Bachelor of Science
- Employee stock purchase plan
- Paid holidays
6d
Care Specialist (Nurse Educator) - San Juan, Puerto Rico (National)
IQVIA —San Juan, PR
- $75,000 - $80,000 a year
- Full-time
- Microsoft Word
- Nursing
- RN License
Especialista De Determinaciones Organizacionales Y Apelaciones
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- Nursing
- RN License
Bilingual Call Center Nurse
Insight Communications —San Juan, PR
- 8 hour shift
- Spanish
- Nursing
- English
Quick Apply
Registered Nurse Care Navigator Bilingual English/Spanish
Duo Health —San Juan, PR
- Monday to Friday
- Background check
- Spanish
- Nursing
- Travel reimbursement
- Mileage reimbursement
Quick Apply
Intake RN (San Juan)
Revival Home Health Care a Centers Company —San Juan, PR
- Full-time
- Mid-level
- Home Health
- Discharge planning
Quick Apply
HD Liaison/First Resp PR (ASEM)
LifeLink Foundation, Inc. —Guaynabo, PR
- Extended hours
- Nursing
- Clean driving record
- Microsoft Excel
- Paid holidays
- Disability insurance
Quick Apply
5d
Medical Case Manager
Family Medicine Group —Carolina, PR
- $11 - $14 an hour
- Full-time
- Bilingual
- HIPAA
- Mid-level
Quick Apply
5d
RN Care Manager - Hybrid (Bengali/Arabic/Chinese Languages Preferred)
Centers Care Solutions —San Juan, PR
- Full-time
- Spanish
- Nursing
- RN License
Quick Apply
Pharmacy Manager
Walgreens —Dorado Municipio, PR
- $56.45 - $69.00 an hour
- Full-time
- Bachelor of Science
- Mid-level
- Patient care
- Continuing education credits
14d
Remote Chronic Care Management LVN CA License
Nsight Health —United States
- $24 - $26 an hour
- Full-time
- Remote
- LVN
- Mid-level
- Organizational skills
- Paid holidays
- Health insurance
Quick Apply
13d
Appeal Analyst RN | Remote | Contract
Walker Healthforce, LLC —United States
- Contract
- Remote
- Nursing
- Microsoft Outlook
- RN License
- Health insurance
- Dental insurance
Quick Apply
Travel ICU RN Job in Tuscaloosa, Alabama
Gifted Healthcare —United States
- $2,646 a week
- Overtime
- Nursing
- Anatomy knowledge
- Medication administration
- Health insurance
- Dental insurance
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nurse case managers jobs near guaynabo, pr

Nurse Care Manager I (NCLEX)

Elevance Health -
San Juan, PR

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Job Details

Full-time
6 days ago

Benefits

Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

Foreign language proficiency
Direct patient care
RN License
Acute care experience

Full Job Description

Nurse Care Manager I

Location: This role enables associates to work virtually full-time, except for 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. This position will be based in Puerto Rico.

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.

Carelon Global Solutions (CGS), a fully owned subsidiary of Elevance Health, is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system.

Our Puerto Rico location operates a bilingual Spanish and English call center, providing clear and precise answers to customer queries.

Schedule: This position will work rotating 8-hour shifts between 8:30 am - 8:30 pm (ET), Monday through Friday. Additional hours, including weekends or holidays, may be required based on operational needs.

The Nurse Care Manager I is 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.

How You Will Make an Impact

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.

Minimum 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.

Preferred Skills, Capabilities, and Experiences:

Fully Bilingual (English & Spanish), Must be able to write, read and speak both languages in a proficiency level preferred.
AS or BS in nursing is strongly preferred.
NCLEX Certification or current unrestricted RN license from one of the 50 states of the United States is highly preferred.
Home health/discharge planning experience preferred.
Certification as a Case Manager or a BS in a health or human services related field also 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. Requires 3 years full-time equivalent of direct clinical care experience to the consumer, 5 years full-time equivalent of direct clinical care experience to the consumer preferred or any combination of education and experience, which would provide an equivalent background, Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager or a BS in a health or human services related field also preferred.

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 include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates 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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act

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Refine Your Search

nurse case managers jobs in guaynabo, pr

Nurse Care Manager I (NCLEX)

Care Specialist (Nurse Educator) - San Juan, Puerto Rico (National)

Especialista De Determinaciones Organizacionales Y Apelaciones

Bilingual Call Center Nurse

Registered Nurse Care Navigator Bilingual English/Spanish

Intake RN (San Juan)

HD Liaison/First Resp PR (ASEM)

Medical Case Manager

RN Care Manager - Hybrid (Bengali/Arabic/Chinese Languages Preferred)

Pharmacy Manager

Remote Chronic Care Management LVN CA License

Appeal Analyst RN | Remote | Contract

Travel ICU RN Job in Tuscaloosa, Alabama

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