Care Manager Specialist

3 weeks ago


Louisville, Kentucky, United States Elevance Health Full time

**Job Summary:** We are seeking a highly skilled Care Manager Specialist to join our team at Elevance Health. This individual will play a crucial role in managing care for members with complex and chronic needs.

Key Responsibilities:

  • Facilitate access to services that cater to the unique health needs of our members.
  • Conduct thorough assessments to identify individual needs and develop tailored care plans.
  • Navigate authorizations and referrals within our benefits structure to implement care plans.
  • Collaborate with internal and external resources to meet identified needs.
  • Evaluate the effectiveness of care management plans and make necessary adjustments.
  • Work closely with Medical Directors and Physician Advisors to ensure alignment with care management treatment plans.
  • Engage in rate negotiation for reimbursement.
  • Support problem-solving and policy development for care management initiatives.

Requirements:

  • A Bachelor's degree in a healthcare-related field, coupled with a minimum of 5 years of clinical experience.
  • An active, unrestricted RN license in the applicable state(s) is mandatory.

Estimated Salary Range:** $65,000 - $85,000 per annum, depending on location and experience.

Benefits: We offer a comprehensive package, including market-competitive compensation, paid holidays, medical, dental, vision, disability benefits, and a 401(k) + match. As an Equal Employment Opportunity employer, we welcome applicants from diverse backgrounds.



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