Nurse Case Manager II

The Elevance Health Companies, Inc.; Louisville (KY); Remote; USD 65,000 - 95,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid Time Off

Incentive bonus programs

Medical insurance

Dental insurance

Vision insurance

Short-term disability

Long-term disability

401(k) matching

Stock purchase plan

Life insurance

Wellness programs

Financial education resources

Job summary

Elevance Health is seeking a Nurse Case Manager II in Kentucky to manage care plans, coordinate services, and optimize member outcomes. This remote role requires in-person training sessions and KY residency, with a hybrid/work-from-home structure and weekly onsite expectations.

Ideal candidates hold an RN license in KY, have 5+ years of clinical experience, and may pursue multistate licensure. Responsibilities include assessment, authorizations, and collaboration with medical Directors to

Qualifications

• Requires BA/BS in a health-related field and minimum of 5 years of clinical experience or equivalent background.
• Current, unrestricted RN license in KY is required.
• Multistate licensure required if providing services in multiple states.

Responsibilities

• Ensures member access to services appropriate to their health need.
• Conducts assessments to identify individual needs and a care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits 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 care plans.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Skills

Care coordination

Communication

Assessment

Education

BA/BS in health-related field

RN license (KY)

Job description

Job Title

Nurse Case Manager II

Job Details

Anticipated End Date: 2026-10-13

Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. Must Reside in KY. 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. This position is not eligible for employment-based sponsorship.

Hours: Monday-Friday: 11:30am - 8pm

Responsibilities

• Ensures member access to services appropriate to their health need
• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment
• Implement 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
• Assists in problem solving with providers, claims or service issues
• Assists with development of utilization/care management policies and procedures

Minimum Requirements

Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.

Current, unrestricted RN license in KY required.

Multi-state licensure is required if this individual is providing services in multiple states.

Preferred Skills, Capabilities and Experience

• Certification as a Case Manager is preferred

Job Level and Family

Job Level: Non-Management Exempt

Workshift: Job Family: MED > Licensed Nurse

Hybrid Workforce Strategy

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.

Benefits

• merit increases
• paid holidays
• Paid Time Off
• 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
• financial education resources

Company Overview

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.

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.

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.

Equal Employment Opportunity Statement

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.

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler.

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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact.

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.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact.

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.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Elevance Health is an Equal Opportunity Employer/Disability/Veterans.