Nurse Case Manager I

Elevance Health

. Perform telephonic care management within scope of licensure for members with complex and chronic care needs .

Posted 9/23/2026full-timeUnited StatesMid-LevelSenior💰 $70,560 - $110,880 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in telephonic care management, developing and implementing individualized care plans for members with complex health needs. Proficient in coordinating resources, negotiating reimbursement rates, and ensuring access to appropriate health services.

Highest-signal resume keywords

Telephonic Care ManagementIndividualized Care Management PlansRN LicenseCase Management CertificationClinical Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care Plan DevelopmentAuthorization and Referral ManagementCare Plan MonitoringNegotiation SkillsIssue Resolution

Soft Skills

Interpersonal CommunicationCollaborationProblem-Solving

Certifications & Qualifications

Case Manager Certification

Industry Keywords

Chronic Care ManagementHealth Services AccessMulti-State LicensurePatient CareClinical Assessment

About the role

Key responsibilities & impact

Perform telephonic care management within scope of licensure for members with complex and chronic care needs
Assess member needs and develop individualized care management plans
Implement care plans through authorizations and referrals within benefits structures or extra-contractual arrangements
Coordinate internal and external resources
Monitor and evaluate care plan effectiveness and modify plans as needed
Interface with Medical Directors and Physician Advisors on treatment plans
Negotiate reimbursement rates when applicable
Assist with provider, claims, and service issue resolution
Ensure member access to appropriate health services

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 providing an equivalent background
Current unrestricted RN license in applicable state(s) required
Multi-state licensure required when providing services in multiple states
Certification as a Case Manager preferred
Ability to work Monday–Friday 8:30am–5:00pm in the associate’s time zone, with 2–4 late shifts per month from 11:30am–8:00pm EST
Must reside within a reasonable commuting distance from a posting location unless an accommodation is granted
Candidates in patient/member-facing roles may be required to become vaccinated against COVID-19 and Influenza

Benefits

Comp & perks

Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401(k) contribution and match
Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
Medical benefits
Dental benefits
Vision benefits
Short-term disability benefits
Long-term disability benefits
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Virtual work flexibility
Required in-person training sessions
COVID-19 and Influenza vaccination coverage/requirement for certain roles