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Full-time
bachelor degree, professional certificate
Sign On Bonus, Merit Increases, Paid Holidays, Paid Time Off, Incentive Bonus Programs, Medical Insurance
Posted 25d ago
Apply by Jul 23
~40 hrs/week
Responsibilities
The Lead Nurse Case Manager manages care for members with complex and chronic needs by developing and monitoring individualized care plans. They also provide leadership by coaching staff, conducting quality audits, and coordinating with medical directors to optimize member health outcomes.
Requirements
Requires a BA/BS in a health-related field, 5 years of clinical experience, and a current unrestricted RN license. Case manager certification is required within three years of hire, with managed care experience being necessary.
Full job description
Anticipated End Date:
2026-07-23
Position Title:
Nurse Case Manager Lead
Job Description:
Telephonic Nurse Case Manager Lead
Sign on Bonus: $3000.
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.
Location: Kentucky, Ohio or Indiana.
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, 11:30- 8 pm EST.
The Telephonic Nurse Case Manager Lead 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 and ensuring member access to services appropriate to their health needs. Performs duties telephonically or on-site such as at hospitals for discharge planning.
How you will make an Impact:
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, chairs and schedules meetings, as well as presents cases for discussion at Grand Rounds/Care Conferences and participates in interdepartmental and/or cross brand workgroups.
May require the development of a focused skill set including comprehensive knowledge of specific disease process or traumatic injury and functions as preceptor for new care management staff.
Participates in audit activities and assists supervisor with management of day-to-day activities, such as monitoring and prioritizing workflow, delivering constructive coaching and feedback, and developing associated corrective action plans at direction of the manager.
Serves as first line contact for conflict resolution.
Develops training materials, completes quality audits, performs process evaluations, and tests and monitors systems/process enhancements.
Minimum Requirements:
Requires a BA/BS in a health related field and 5 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.
Case manager certification required within 3 years of starting in this role.
Preferred Skills, Capabilities, and Experiences:
Certification as a Case Manager is preferred.
BS in a health or human services related field preferred.
Managed care experience necessary..
Case management experience a plus.
Job Level:
Non-Management Exempt
Workshift:
2nd 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 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.
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.
Related keywords
RN LicenseCase Manager CertificationManaged CareCare ContinuumChronic CareUtilization ManagementTelephonic Case ManagementHealthcareClinical ExperienceCare Plan DevelopmentPatient AdvocacyMedical DirectivesQuality AuditDischarge Planning
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
Health CareWellnessHealth InsurancePersonal Health
Based on 1326 listings with disclosed salaries, most healthcare jobs in Indiana pay between $65k–$171k per year. Individual offers vary with seniority, company size, and specialization.
How many Healthcare jobs are open in Indiana right now?
There are currently 14,349 open healthcare positions in Indiana listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Healthcare roles in Indiana?
Companies currently hiring include Indiana University Health, American Senior Communities, Franciscan Health, Ascension, CVS Health, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Healthcare jobs in Indiana?
Yes — 1045 of the 14349 open healthcare positions offer remote or hybrid work (362 remote, 683 hybrid).
How do I apply for Healthcare jobs in Indiana?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.