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Elevance Health logo
Elevance Health

Elevance Health is fueled by a purpose to strengthen the health of humanity by redefining health, reimagining the health system, and improving communities. Reco

Nurse Case Manager I

Location

United States

Posted

129 days ago

Salary

0

Seniority

Lead

No structured requirement data.

Job Description

Nurse Case Manager I

Elevance Health

Anticipated End Date: 2026-03-18 Position Title: Nurse Case Manager I Job Description: Telephonic Nurse Case Manager I Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Must reside in Kentucky. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Hours: Monday - Friday, 8:30-5 or 9:30-6 pm EST. The Telephonic Nurse Case Manager I is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning. How you will make an Impact: - Ensures member access to services appropriate to their health needs. - Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. - Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure 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 the development of care management treatment plans. - Negotiates rates of reimbursement, as applicable. - Assists in problem solving with providers, claims or service issues. - Assists with development of utilization/care management policies and procedures. Minimum Requirements: - 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 applicable state(s) required. - Multi-state licensure is required if this individual is providing services in multiple states. Preferred Skills, Capabilities, and Experiences: - Certification as a Case Manager is preferred. - BS in a health or human services related field preferred. - Kentucky RN License. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

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Creating remarkable health experiences, freeing people to be their best.

Counselor129 days ago
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Elevance Health logo

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Elevance Health

Elevance Health is fueled by a purpose to strengthen the health of humanity by redefining health, reimagining the health system, and improving communities. Reco

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Fort Hays State University logo

Regional Admissions Counselor

Fort Hays State University

FHSU is located in Hays, a vibrant college town of approximately 20,000, located halfway between Kansas City and Denver on Interstate 70. Hays is the regional center for education, health care, professional services, shopping, culture, and recreation for the western half of Kansas. Excellent recreational programs and facilities, including the Center for Health Improvement, Hays Aquatic Park, and extensive walking, running, and biking trails. Within 45 minutes of two large lakes that offer great opportunities for boating, fishing, and camping. Hays Municipal Airport provides connecting service to Denver with several flights daily. Home to excellent Pre-K and K-12 public and private schools. Over 60 restaurants, major retail outlets, and a low unemployment rate. Safe, welcoming, low-cost, high-quality living environment.

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Elevance Health logo

Behavioral Health Case Manager 1

Elevance Health

Elevance Health is fueled by a purpose to strengthen the health of humanity by redefining health, reimagining the health system, and improving communities. Reco

Counselor129 days ago

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. The Behavioral Health Case Manager is responsible for performing case management telephonically and/or by home visits within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs. How you'll make a difference: - Uses appropriate screening criteria knowledge and clinical judgment to assess member needs. - Conducts assessments to identify individual needs and develops care plan to address objectives and goals as identified during assessment. - Monitors and evaluates effectiveness of care plan and modifies plan as needed. - Supports member access to appropriate quality and cost effective care. - Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers. Qualifications - Requires MA/MS in social work, counseling, or a related behavioral health field or a degree in nursing, and minimum of 3 years clinical experience in social work counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background. - Current active unrestricted license such as RN, LCSW (as applicable by state law and scope of practice), LMHC, LICSW, LPC (as allowed by applicable state laws), LMFT, LMSW (as allowed by applicable state laws) or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required. Requirements - Experience in case management and telephonic and/or in person coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders preferred. Benefits - Comprehensive benefits package. - Incentive and recognition programs. - Equity stock purchase. - 401k contribution (all benefits are subject to eligibility requirements).

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Job Closed