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Posted: 10/19/2026Nurse Case Manager II
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 problem-solving skills in clinical settings.
Highest-signal resume keywords
RN LicenseCase Management CertificationClinical ExperienceCare Plan DevelopmentUtilization Management
About the role
Key responsibilities & impact- Manage care for members with complex and chronic care needs within the scope of licensure
- Assess members and develop, implement, coordinate, monitor, and evaluate care plans
- Perform duties telephonically
- Ensure member access to services appropriate to health needs
- Conduct assessments to identify individual needs and care management objectives
- 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 as applicable
- Assist with provider, claims, or service issue problem solving
- Assist with developing utilization and care management policies and procedures
Requirements
What you’ll need- BA/BS in a health-related field and minimum of 5 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 if providing services in multiple states
- Must be available to work an 8-hour shift between 8:00 am and 8:00 pm
- Certification as a Case Manager preferred
- Previous experience as a case manager strongly preferred
- For URAC accredited areas: BA/BS and minimum of 5 years of clinical care experience, or equivalent combination of education and experience
- For URAC accredited areas: current and active RN license required in applicable state(s)
- For URAC accredited areas: multi-state licensure required when providing services in multiple states
- For URAC accredited areas: certification as a Case Manager and BS in a health or human services-related field preferred
- Candidates must reside within a reasonable commuting distance from a posting location unless 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
- Maximum flexibility and autonomy
- Personal and professional growth opportunities
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 Plan CoordinationAssessment SkillsTelephonic Care ManagementReimbursement NegotiationReferral FacilitationPolicy DevelopmentMonitoring Care EffectivenessProblem SolvingMulti-State LicensureClinical Care Experience
Soft Skills
Interpersonal CommunicationCollaborationNegotiationOrganizational SkillsAdaptability
Certifications & Qualifications
Case Manager Certification
Industry Keywords
Chronic Care ManagementHealth ServicesUtilization ReviewPatient CareHealthcare Compliance