Remote RN Case Manager II - KY

Elevance Health, Inc.; Louisville (KY); Hybrid; USD 70,000 - 95,000; Full time

Job summary

Elevance Health is seeking a skilled Case Manager RN in Kentucky. This role focuses on assessing patient needs, designing and implementing care plans, and coordinating resources within the benefits framework and external arrangements. It requires a strong clinical background and licensure in Kentucky.

The position supports a hybrid/virtual work model with in-person training sessions. Compliance with vaccination policy and loyalty to patient-centered care are emphasized.

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; multi-state licensure required if practicing in multiple states.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify needs and develops care management plans.
• Implements care plans by facilitating authorizations/referrals within benefits or extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of care management plans and adjusts as needed.
• Interacts with Medical Directors and Physician Advisors on care management plans.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Skills

RN license KY

Case management

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a skilled Case Manager RN in Kentucky. This role focuses on assessing patient needs, designing and implementing care plans, and coordinating resources within the benefits framework and external arrangements. It requires a strong clinical background and licensure in Kentucky.

The position supports a hybrid/virtual work model with in-person training sessions. Compliance with vaccination policy and loyalty to patient-centered care are emphasized.