Indianapolis, Indiana, United States · Hybrid
Anticipated End Date: 2026-08-14 Position Title: LTSS Service Coordinator - RN Clinician (Clark County, IN) Job Description: LTSS Service Coordinator - RN Clinician The candidate should reside in Clark County, IN. Field:…
Skills: Case management, Clinical assessment, Care planning, Utilization management, Chronic illness management
Miami, Florida, United States · Hybrid
Anticipated End Date: 2026-08-21 Position Title: Pediatric Nurse Case Manager I Job Description: Pediatric Nurse Case Manager Location: The ideal candidate will reside within the following areas: Juno Beach, Jupiter, Jup…
Skills: Care management, Clinical assessment, Care plan development, Discharge planning, Pediatric nursing
Costa Mesa, California, United States · Remote OK
$90k–$161k/yr
Anticipated End Date: 2026-08-28 Position Title: DRG Clinical Validation Lead Job Description: DRG Clinical Validation Lead Anticipated End Date: 8/28/2026 Virtual: This role enables associates to work virtually full-tim…
Skills: Clinical validation, DRG coding, Medical necessity assessment, Managed care, Utilization review
Rocky Hill, Connecticut, United States · Hybrid
Anticipated End Date: 2026-08-31 Position Title: Technical Project Manager – Enterprise Applications & Analytics Platforms Job Description: Technical Project Manager – Enterprise Applications & Analytics Platforms Locati…
Skills: Project management, Tableau server administration, SAS administration, Windows server maintenance, Active directory
Lake Mary, Florida, United States · Hybrid
$243k–$365k/yr
Anticipated End Date: 2026-08-12 Position Title: Distinguished Engineer Job Description: Distinguished Engineer Locations: This role requires associates to be in-office 1-2 days per week, fostering collaboration and conn…
Skills: Artificial intelligence, Large language models, Distributed systems, Python, Java
Indianapolis, Indiana, United States · Hybrid
Anticipated End Date: 2026-08-14 Position Title: LTSS Service Coordinator - RN Clinician (La Porte County, IN & Porter County, IN) Job Description: LTSS Service Coordinator - RN Clinician The candidate should reside in L…
Skills: Case management, Care planning, Clinical assessment, Chronic illness management, Utilization management
Akron, Ohio, United States · Hybrid
Anticipated End Date: 2026-08-21 Position Title: Hemophilia Account Executive- Paragon Healthcare – Ohio, Indiana, Illinois Job Description: Hemophilia Account Executive- Paragon Healthcare – Ohio, Indiana, Illinois Sale…
Skills: Sales, Relationship building, Territory management, Forecasting, Negotiation
Miami, Florida, United States · Hybrid
Anticipated End Date: 2026-08-21 Position Title: Program Administrator, Vendor Management Job Description: Program Administrator, Vendor Management Hybrid 1: This role requires associates to be in-office 1 - 2 days per w…
Skills: Program administration, Client facing programs, Project management, Vendor management, Microsoft excel
Rocky Hill, Connecticut, United States · Hybrid
Anticipated End Date: 2026-09-06 Position Title: Behavioral Health Case Mgr II Job Description: Behavioral Health Case Mgr II - Connecticut *Candidates Must Reside in the state of Connecticut. Location: Hybrid 1: This ro…
Skills: Case management, Behavioral health, Substance use disorder treatment, Care coordination, Resource navigation
Wallingford, Connecticut, United States · Hybrid
$24/hr–$41/hr
Anticipated End Date: 2026-09-01 Position Title: Referral & Resource Specialist Job Description: Referral & Resource Specialist Location: Candidates must reside in one of the following states to be considered : MASSACHUS…
Skills: Behavioral health, Crisis intervention, Safety screening, Assessment, Telephonic intervention
South Portland, Maine, United States · Hybrid
$15/hr–$24/hr
Anticipated End Date: 2026-09-11 Position Title: Customer Care Representative I - South Portland, ME & Roanoke, VA Job Description: Customer Care Representative I South Portland, ME & Roanoke, VA Location: This role enab…
Skills: Customer service, Telephone communication, Written communication, Data entry, Problem solving
Rocky Hill, Connecticut, United States · Hybrid
Anticipated End Date: 2026-09-06 Position Title: Network Mgmt Consultant Job Description: Network Management Consultant (Behavioral Health) - Connecticut *Candidates Must Reside in the state of Connecticut. Location: Hyb…
Skills: Provider relations, Network management, Behavioral health, Community engagement, Resource coordination
Plano, Texas, United States · Hybrid
Anticipated End Date: 2026-09-04 Position Title: Patient Financial Coordinator - Patient Access Job Description: Patient Financial Coordinator – Patient Access Location: 3033 W President George Bush Hwy, STE 100, Plano, …
Skills: Financial verification, Pharmacy operations, Patient access, Co-pay assistance, Medical billing
Boston, Massachusetts, United States · Remote OK
$127k–$158k/yr
Anticipated End Date: 2026-08-15 Position Title: Nurse Practitioner, Bilingual (100% Virtual) - CareBridge Job Description: CareBridge Advance Practice Provider, Nurse Practitioner Bilingual $5,000 Sign-on Bonus *Seeking…
Skills: Nurse practitioner, Bilingual, Spanish, Hindi, Electronic medical records
Atlanta, Georgia, United States · Hybrid
$125k–$188k/yr
Anticipated End Date: 2026-08-21 Position Title: Pharmacist Consultant (Call Center) Job Description: Pharmacist Consultant (Call Center) Virtual: This role enables associates to work virtually full-time, except for requ…
Skills: Drug therapy evaluation, Medication history review, Disease management, Clinical consultation, Physician communication
Plano, Texas, United States · Hybrid
Anticipated End Date: 2026-08-12 Position Title: Referral Specialist III - Paragon Infusion Centers Job Description: Referral Specialist III - Paragon Infusion Centers Location: TX-PLANO, 3033 W PRESIDENT GEORGE BUSH HWY…
Skills: Precertification, Prior authorization, Medical terminology, ICD coding, CPT coding
Quinte West, Ontario, Canada · Hybrid
$90k–$170k/yr
Anticipated End Date: 2026-08-28 Position Title: Actuarial Analyst III Job Description: Actuarial Analyst III Location: This role requires associates to be in-office 1-2 days per week, fostering collaboration and connect…
Skills: Excel, SQL, SAS, Actuarial Analysis, Risk Contract Implementation
Plano, Texas, United States · Hybrid
Anticipated End Date: 2026-08-19 Position Title: Pharmacy Technician II Specialty Job Description: Pharmacy Technician II Specialty Location: TX- Plano, 3033 W. President George Bush Hwy, Ste 100 Hybrid: This role requir…
Skills: Sterile compounding, Pharmacy operations, Inventory management, Patient care, IV preparation
Lake Mary, Florida, United States · Hybrid
Anticipated End Date: 2026-09-13 Position Title: BCBA-D/PsyD Autism Specialist Psychologist-Clinical Reviewer (Florida Licensed) Job Description: BCBA-D/PsyD Autism Specialist Psychologist Location: Tampa, FL, Lake Mary,…
Skills: Clinical Review, Utilization Management, Psychological Testing, Neuropsychological Testing, Case Review
St. Louis, Missouri, United States · Remote OK
Anticipated End Date: 2026-08-15 Position Title: Provider Reimbursement Manager Job Description: Provider Reimbursement Manager LOCATION: Virtual eligible - Eastern or Central time zone highly preferred. You should be wi…
Skills: Provider reimbursement strategy, Fee schedule development, Clinical editing rules, Financial modeling, Economic analysis
Indianapolis, Indiana, United States • Hybrid
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The RN Service Coordinator manages member care plans, conducts clinical assessments, and provides oversight to non-RN clinicians to optimize health outcomes. They coordinate services across physical, behavioral, and social health domains while ensuring cost-effective utilization of benefits.
Candidates must hold a current, active, and unrestricted RN license and possess at least 3 years of experience in case management or working with individuals with chronic illnesses. A high school diploma or equivalent is the minimum educational requirement, with higher degrees preferred.
Field: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. Alternate locations may be considered if candidates reside within a commuting distance from an office.
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.
The LTSS Service Coordinator - RN Clinician is responsible for overall management of member's case within the scope of licensure. Provide direction and oversight to non-RN clinicians participating in the member's case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. Responsible for performing telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.
Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team.
Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits.
Obtains a thorough and accurate member history to develop an individual care plan.
Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians.
Identifies members that would benefit from an alternative level of care or other waiver programs.
The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services.
May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible.
Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management treatment plans.
May also assist in problem solving with providers, claims or service issues.
Provide direction and oversight to LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member by, for example, assigning appropriate tasks to the non-RN clinicians, verifying and interpreting member information obtained by these individuals, conducting additional assessments, as necessary, to develop, monitor, evaluate, and revise the member's care plan to meet the member's needs, and reviewing and providing input on the non-RN clinicians' performance on a regular basis.
HS diploma or equivalent.
Minimum of 3 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background.
Current, active valid and unrestricted RN license in applicable state(s) required.
May require state-specified certification based on state law and/or contract.
Associates/MA/MS in Health/Nursing preferred.
Travels to worksite and other locations as necessary.
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.
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.
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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. 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.
NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.
Fueled by our bold purpose to improve the health of humanity, we are transforming from a traditional health benefits organization into a lifetime trusted health partner. Our nearly 100,000 associates serve more than 118 million people, at every stage of health. We address a full range of needs with an integrated whole health approach, powered by industry-leading capabilities and a digital platform for health. We believe that improving health for everyone is possible. It begins by redefining health, reimagining the health system, and strengthening our communities.
Offices: 220 Virginia Ave, Indianapolis, Indiana 46204, US
Fueled by our bold purpose to improve the health of humanity, we are transforming from a traditional health benefits organization into a lifetime trusted health partner. Our nearly 100,000 associates serve more than 118 million people, at every stage of health. We address a full range of needs with an integrated whole health approach, powered by industry-leading capabilities and a digital platform for health. We believe that improving health for everyone is possible. It begins by redefining health, reimagining the health system, and strengthening our communities.
Offices: 220 Virginia Ave, Indianapolis, Indiana 46204, US
