Nurse Case Manager I

Elevance Health

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

Posted 10/2/2026full-timeUnited StatesMid-LevelSenior💰 $67,000 - $105,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care management for members with complex and chronic care needs, including assessment, care plan development, and coordination of services. Holds a current RN license and preferably a Case Manager certification, with a strong focus on effective communication and problem-solving in healthcare settings.

Highest-signal resume keywords

RN LicenseCase Manager CertificationCare Plan DevelopmentClinical ExperienceCare Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care ManagementAssessmentCare Plan ImplementationDischarge PlanningAuthorization FacilitationReimbursement NegotiationMonitoring Care EffectivenessProblem-SolvingCoordination of ResourcesEvaluation of Care Plans

Soft Skills

CommunicationInterpersonal SkillsNegotiationCollaborationOrganizational Skills

Certifications & Qualifications

Case Manager Certification

Industry Keywords

Chronic Care ManagementHealth ServicesClinical CareMulti-State LicensureURAC Accreditation

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 across the care continuum
Perform duties telephonically or on-site, including at hospitals for discharge planning
Ensure member access to services appropriate to health needs
Conduct assessments and create care management plans addressing identified objectives and goals
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 plan effectiveness and modify plans as necessary
Interface with Medical Directors and Physician Advisors on care management treatment plans
Negotiate reimbursement rates when applicable
Assist with problem-solving involving providers, 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 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 is preferred
For URAC accredited areas: BA/BS and 3 years of clinical care experience; or equivalent combination of education and experience
Current and active RN license required in applicable state(s)
Certification as a Case Manager and a BS in a health or human services related field preferred
Ability to work an 8-hour shift between 8:00 am and 8:00 pm EST, Monday to Friday
Additional hours may be necessary based on company needs
Candidates must reside within a reasonable commuting distance of 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

Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
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) with company match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Virtual work flexibility
Accommodation support where required by law