Location: Overland Park KS

Hours: M – F Standard Working hours

Travel: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Position Overview:

Responsible for managing a team of physical health practitioners responsible for coordinating member service, utilization, access, care coordination and/or concurrent review to ensure cost effective utilization of health and mental health for one or more member product populations of varying medical complexity ensuring the delivery of essential services that address the total healthcare needs of members.

How You Will Make an Impact:

• Manages and oversees team responsible in case finding and coordinating cases that involve comorbid conditions

• Coordinates service delivery to include member assessment of physical and psychological factors

• Partners with providers to establish short and long term goals that meet the members needs, functional abilities, and referral sources requirements

• Identifies members with potential for high risk complications

• Reviews benefit systems and cost benefit analysis

• Evaluates medical, mental health and substance abuse service for cost containment

• Supports program compliance and assists in identifying opportunities to improve the customer service and quality outcomes

• Supports quality initiatives and activities, including adherence to National Committee for Quality Assurance (NCQA) standards and HEDIS reporting

• Hires, trains, coaches, counsels, and evaluates performance of direct reports

Required Qualifications:

• Requires BA/BS and minimum of 5 years of experience in Health Care Management; or any combination of education and experience, which would provide an equivalent background

• Current active unrestricted RN, PA, LSW, LCSW, LPC, LMHC or other accepted license (as allowed by applicable state laws) and any other state or federal requirements that may apply is required

Preferred Qualifications:

• Experience with Social Work strongly preferred

• Leadership experience preferred

• Experience in field work strongly preferred

• Advanced Microsoft office suite experience (Excel, word, Powerpoint)

• Data analysis experience preferred

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.