Field-Based RN Case Manager – Kansas Medicaid

Elevance Health; Leawood (KS); Hybrid; USD 75,000 - 95,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical, dental, vision coverage

401(k) + match

Job summary

Elevance Health in Kansas seeks a Nurse Case Manager for Kansas Medicaid to assess, develop, implement, and monitor care plans for members with complex and chronic needs, coordinating care across the continuum. Assessments are conducted both virtually and on-site at hospitals, community centers, or homes to ensure appropriate services.

You must reside in Kansas and be available for Region 1. Hours are 8am–5pm, Monday to Friday, with 10–15% travel in Northeast Kansas.

Qualifications

• Requires BA/BS in a health-related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted RN license in the state of Kansas is required.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments virtually and in person to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
• Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.

Skills

Computer proficiency

Education

BA/BS in health-related field

Job description

Elevance Health in Kansas seeks a Nurse Case Manager for Kansas Medicaid to assess, develop, implement, and monitor care plans for members with complex and chronic needs, coordinating care across the continuum. Assessments are conducted both virtually and on-site at hospitals, community centers, or homes to ensure appropriate services.

You must reside in Kansas and be available for Region 1. Hours are 8am–5pm, Monday to Friday, with 10–15% travel in Northeast Kansas.