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Nurse Case Manager II
Elevance Health. Provide care management within the scope of licensure for members with complex and chronic care needs .
Posted 11/4/2026full-timeWoodland Hills • California • United StatesMid-LevelSenior💰 $42 - $66 per hourWebsite
Core 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 negotiation skills for reimbursement and resource coordination.
Highest-signal resume keywords
Care ManagementRN LicenseClinical ExperienceCase Management CertificationAssessment and Care Planning
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 DevelopmentDischarge PlanningUtilization ManagementCare CoordinationAssessment TechniquesReimbursement NegotiationPolicy Development
Soft Skills
CommunicationInterpersonal SkillsProblem-Solving
Certifications & Qualifications
Case Manager Certification
Industry Keywords
Chronic Care ManagementHealth ServicesMulti-State LicensurePatient CareTelephonic Care Management
About the role
Key responsibilities & impact- Provide care management within the scope of licensure for members with complex and chronic care needs
- Assess members and 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 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 modify care management plans as necessary
- Interface with Medical Directors and Physician Advisors on treatment plans
- Negotiate reimbursement rates as applicable
- Assist with provider, claims, or service issues
- Assist with development of 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 and active RN license required in applicable state(s)
- Multi-state licensure required when providing services in multiple states
- Certification as a Case Manager preferred
- BS in a health or human services related field preferred
- Ability to work 9:00–5:30 Pacific time with 1–2 evening shifts (11:30–8:00 Pacific time) per week
- One late shift per month must be Friday
- 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
- 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 full-time work arrangement
- Flexible work-life integration
- Required in-person training sessions
- COVID-19 and Influenza vaccination support/requirements for certain patient/member-facing roles