Nurse Case Manager Lead – Telephonic Care Coordination

Elevance Health, Inc.; Louisville (KY); Hybrid; USD 90,000 - 134,000; Full time

Benefits offered by this job

Sign-on bonus

Job summary

Elevance Health, Inc. is seeking a Telephonic Nurse Case Manager Lead in Louisville, KY to oversee care management for members with complex needs and coordinate care plans across the care continuum.

This role involves telephonic and on-site duties, including collaboration with Medical Directors and staff to ensure timely access to services. Applicants should have a BA/BS in a health-related field, an active RN license, and case management certification within 3 years.

Qualifications

• Requires a BA/BS in a health related field and 5 years of clinical experience.
• Current, unrestricted RN license in applicable state(s) required.
• Case manager certification required within 3 years of starting in this role.
• Preferred: Certification as a Case Manager.
• BS in a health or human services related field preferred.
• Managed care experience necessary.
• Case management experience a plus.

Responsibilities

• Handles care management for members with complex and chronic needs by assessing and developing care plans.
• Implements care plans and coordinates referrals within benefits structure or through extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates care management effectiveness and adapts as needed.
• Interacts with Medical Directors and Physician Advisors on treatment plans.
• May participate in policy development and audits; supports day-to-day workflow.

Skills

RN license

Case management

Clinical experience

Certification within 3 years

Education

BA/BS in health related field

Job description

Elevance Health, Inc. is seeking a Telephonic Nurse Case Manager Lead in Louisville, KY to oversee care management for members with complex needs and coordinate care plans across the care continuum.

This role involves telephonic and on-site duties, including collaboration with Medical Directors and staff to ensure timely access to services. Applicants should have a BA/BS in a health-related field, an active RN license, and case management certification within 3 years.