RN Case Manager: Telephonic & Field – Kansas Medicaid

Elevance Health; Hugoton (KS); On-site; USD 65,000 - 85,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager in Kansas to perform care management for members with complex and chronic needs, coordinating care telephonically and on-site as needed. You will assess, develop, and monitor care plans across the care continuum to optimize health outcomes.

The role requires an unrestricted RN license in Kansas, a BA/BS in a health-related field, and is field-based with travel to various counties (Finney, Hodgeman, Hamilton, Kearny, and others).

Qualifications

• Requires BA/BS in a health-related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted RN license in the state of Kansas is required.
• Computer proficiency strongly preferred.

Responsibilities

• Performs care management within licensure to assess, develop, implement, coordinate, monitor, and evaluate care plans for members with complex and chronic care needs.
• Performs assessments and coordination of care telephonically and on-site for care coordination and discharge planning.
• Ensures member access to services appropriate to health needs.
• Conducts assessments virtually and in person to identify needs and develops a care management plan.
• Implements care plans by facilitating authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Monitors and evaluates care management effectiveness; coordinates with Medical Directors and Physician Advisors.
• Negotiates rates of reimbursement, as applicable; assists in problem solving with providers, claims, or service issues.

Skills

Computer proficiency

Education

BA/BS in a health-related field

RN license (Kansas)

Job description

Elevance Health is seeking a Nurse Case Manager in Kansas to perform care management for members with complex and chronic needs, coordinating care telephonically and on-site as needed. You will assess, develop, and monitor care plans across the care continuum to optimize health outcomes.

The role requires an unrestricted RN license in Kansas, a BA/BS in a health-related field, and is field-based with travel to various counties (Finney, Hodgeman, Hamilton, Kearny, and others).