Nurse Case Manager II

🔥 0 minutes ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Elevance Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Elevance Health is transforming from a traditional health benefits organization into a lifetime trusted health partner, driven by a bold purpose to improve the health of humanity. With nearly 100,000 associates, they serve over 118 million people and utilize an integrated whole health approach supported by industry-leading capabilities and a digital health platform. Their mission includes redefining health, reimagining the health system, and strengthening communities.

📋 Description

• Perform care management within the scope of licensure for members with complex and chronic care needs • Assess, develop, implement, coordinate, monitor, and evaluate care plans across the care continuum • Perform duties telephonically or on-site, including at hospitals for discharge planning • Ensure member access to services appropriate to health needs • Conduct assessments and develop care management plans addressing identified objectives and goals • Facilitate authorizations and referrals within the benefits structure or through extra-contractual arrangements • Coordinate internal and external resources to meet identified needs • Monitor and evaluate care plan effectiveness and modify plans as necessary • Interface with Medical Directors and Physician Advisors on care management treatment plans • Negotiate reimbursement rates, as applicable • Assist with provider, claims, or service issue problem solving • Assist with development of utilization/care management policies and procedures

🎯 Requirements

• Candidates must reside in Kentucky • BA/BS in a health related field and minimum of 5 years of clinical experience; or any combination of education and experience providing an equivalent background • Current, unrestricted RN license in applicable state(s) required • Multi-state licensure required if providing services in multiple states • Certification as a Case Manager is preferred • BS in a health or human services related field preferred • Candidates must be within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law • Certain patient/member-facing roles require vaccination against COVID-19 and Influenza, unless an acceptable explanation is provided

🏖️ Benefits

• merit increases • paid holidays • Paid Time Off • incentive bonus programs • medical benefits • dental benefits • vision benefits • short and long term disability benefits • 401(k) +match • stock purchase plan • life insurance • wellness programs • financial education resources • Virtual full-time work, except for required in-person training sessions