Lead Nurse Case Manager – Care Coordination Leader

IntelliResume; Kentucky; On-site; USD 90,000 - 134,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase & 401k

Job summary

Elevance Health is seeking a Nurse Case Manager Lead for care management of members with complex and chronic care needs. The role supports telephonic and on-site care in Louisville, KY, focusing on assessing, developing, implementing, coordinating, monitoring, and evaluating care plans.

Ideal candidates have a BA/BS in a health-related field, at least 5 years of clinical experience, and an active RN license in applicable states.

Qualifications

• BA/BS in a health-related field is required.
• Minimum 5 years of clinical experience.
• Current, unrestricted RN license in applicable state(s).
• Case manager certification within 3 years of starting.

Responsibilities

• Assess patients and develop care management plans.
• Coordinate authorizations and referrals.
• Work with providers and payers to optimize care and reimbursement.
• Monitor care plans and adjust as needed.
• Collaborate with Medical Directors and Physician Advisors on treatment plans.
• Develop utilization/care management policies and procedures.
• Participate in audits and day-to-day management tasks.
• Serve as first point of contact for conflict resolution.

Skills

Care coordination

Case management

Nursing

Telephonic support

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Nurse Case Manager Lead for care management of members with complex and chronic care needs. The role supports telephonic and on-site care in Louisville, KY, focusing on assessing, developing, implementing, coordinating, monitoring, and evaluating care plans.

Ideal candidates have a BA/BS in a health-related field, at least 5 years of clinical experience, and an active RN license in applicable states.