Remote Nurse Case Manager II — Care Coordination

The Elevance Health Companies, Inc.; Louisville (KY); Remote; USD 65.000 - 95.000; Vollzeit

Benefits dieser Stelle

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

Zusammenfassung

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

Qualifikationen

• 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.

Aufgaben

• 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.

Kenntnisse

Care coordination

Communication

Assessment

Ausbildung

BA/BS in health-related field

RN license (KY)

Jobbeschreibung

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