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Posted: 10/19/2026Nurse Case Manager, 100% Virtual
Elevance HealthCore Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care management for members with complex and chronic needs, including assessment, care plan development, and coordination of services. Holds a current RN license and possesses strong case management and home health experience.
Highest-signal resume keywords
RN LicenseCase Management CertificationClinical ExperienceCare Plan DevelopmentHome Health Experience
About the role
Key responsibilities & impact- Perform care management within the scope of licensure for members with complex and chronic care needs
- Assess, develop, implement, coordinate, monitor, and evaluate care plans
- Optimize member health care across the care continuum
- Perform duties telephonically or on-site, such as at hospitals for discharge planning
- Ensure member access to services appropriate to health needs
- Conduct assessments and develop specific care management plans
- Facilitate authorizations and referrals within the benefits structure or through extra-contractual arrangements
- Coordinate internal and external resources to meet identified needs
- Monitor and evaluate care management plan effectiveness and modify plans as necessary
- Interface with Medical Directors and Physician Advisors on care management treatment plans
- Negotiate reimbursement rates, as applicable
- Assist with provider, claims, or service issues
Requirements
What you’ll need- 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 providing services in multiple states
- Certification as a Case Manager is preferred
- Prior case management experience is strongly preferred
- Home health experience is strongly preferred
- Monday–Friday availability, 11am–8pm CST
- Candidates must reside within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law
- New candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza, unless an acceptable explanation is provided
Benefits
Comp & perks- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short-term disability benefits
- Long-term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Virtual full-time work arrangement, except for required in-person training sessions
- Accommodation support for applicants who require it
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care ManagementAssessmentCare Plan ImplementationMonitoring and EvaluationDischarge PlanningAuthorization FacilitationResource CoordinationNegotiation SkillsReimbursement Rate NegotiationTelephonic Care Management
Soft Skills
Interpersonal CommunicationProblem SolvingCollaboration
Certifications & Qualifications
Case Manager Certification
Industry Keywords
Chronic Care ManagementHealth Care ContinuumMulti-State LicensurePatient CareCOVID-19 Vaccination Requirement