Remote Nurse Case Manager II – RN (KY)

Elevance Health; Louisville (KY); Remote; USD 70,000 - 90,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager II to manage care plans telephonically for members with complex and chronic needs. The role requires assessing, developing, coordinating, and monitoring care plans to optimize health outcomes.

Requires a BA/BS in a health-related field and an active RN license in Kentucky with at least 5 years of clinical experience. Multi-state licensure is needed if services span multiple states.

Qualifications

• BA/BS in a health-related field is required.
• Current, unrestricted RN license in KY is required.
• Multi-state licensure is required if serving multiple states.

Responsibilities

• Ensures member access to services appropriate to health needs.
• Conducts assessments to identify needs and formulate care plans.
• Implements care plans by facilitating authorizations/referrals.
• Coordinates internal and external resources to meet needs.
• Monitors and evaluates effectiveness of care plans and adjusts as needed.
• 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.

Skills

Care assessment

Care planning

Telephonic management

Provider coordination

Utilization reviews

Education

BA/BS in health-related field

RN license in KY

Job description

Elevance Health is seeking a Nurse Case Manager II to manage care plans telephonically for members with complex and chronic needs. The role requires assessing, developing, coordinating, and monitoring care plans to optimize health outcomes.

Requires a BA/BS in a health-related field and an active RN license in Kentucky with at least 5 years of clinical experience. Multi-state licensure is needed if services span multiple states.