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Posted: 10/20/2026Nurse Case Manager II, RN
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 care needs, utilizing strong clinical assessment and coordination skills. Proficient in telephonic care management and familiar with managed care practices and policies.
Highest-signal resume keywords
RN LicenseCase Management ExperienceTelephonic Nursing ExperienceManaged Care ExperienceClinical Experience
About the role
Key responsibilities & impact- Conduct care management for members with complex and chronic care needs within the scope of licensure
- Screen, assess, stratify risk, plan, implement care coordination, follow up, transition members, communicate post-transition, and evaluate outcomes
- Conduct outbound, 100% telephonic care management
- Ensure member access to services appropriate to their 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 management plan effectiveness and modify plans as necessary
- Interface with Medical Directors and other health professionals on treatment plans
- Assist with provider, claims, or service issue resolution
- 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 RN license in applicable state(s) is required
- Multi-state RN licensure is required upon hire for providing services in multiple states
- Active California RN license is highly preferred
- Minimum 2 years of direct Case Management experience
- Certification as a Case Manager, CCM is preferred
- Telephonic and/or virtual nursing experience
- Managed Care experience
- Minimum 2 years’ experience in acute care setting
- Experience with Microsoft Office suite and/or ability to learn new computer programs/systems/software quickly
- Ability to speak and type at the same time
- Ability to work Monday–Friday, 9:00 am to 5:30 pm PST or MST, with two evening shifts weekly from 11:30 am to 8:00 pm PST or MST
- Candidates must reside within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law
- Candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza, unless they provide an acceptable explanation
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 and 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
- Vaccination support/coverage as applicable
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 ManagementRisk AssessmentCare CoordinationCare Management PlansUtilization ManagementOutcome EvaluationProvider Issue ResolutionMicrosoft Office SuiteAcute Care ExperienceAuthorization Facilitation
Soft Skills
Communication SkillsInterpersonal SkillsOrganizational SkillsProblem-Solving SkillsAbility to Multitask
Certifications & Qualifications
CCM Certification
Industry Keywords
Managed CareTelehealthChronic Care ManagementHealth ServicesPatient Care