RN Nurse Case Manager II, California HMO

Elevance Health

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

Posted 10/7/2026full-timeRemote • California • United StatesMid-LevelSenior💰 $83,248 - $136,224 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in care management for individuals with complex and chronic care needs, including assessment, care plan development, and coordination of services. Holds a current RN license and possesses significant clinical experience in managed care settings.

Highest-signal resume keywords

RN LicenseCare ManagementClinical ExperienceCase Management CertificationDischarge Planning

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Care Plan DevelopmentAssessmentCare CoordinationUtilization ManagementProblem Solving

Soft Skills

CommunicationInterpersonal SkillsOrganizational Skills

Certifications & Qualifications

Case Manager Certification

Industry Keywords

Chronic DiseasesManaged CareDischarge PlanningClinical ExperienceHealth-Related Field

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 telephonic duties with medical groups, providers, community resources, and members for discharge planning
Ensure member access to services appropriate to their health needs
Conduct assessments to identify individual needs and develop specific care management plans
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
Assist with problem solving involving providers, 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 RN license in the state of California required
Case Manager experience within hospital or managed care setting is preferred
Clinical experience working with individuals with various chronic diseases, illnesses and medical needs strongly preferred
Knowledge/experience with discharge planning preferred
Certification as a Case Manager is preferred
Work within an 8-hour shift between 8am and 6pm Pacific Time
Candidates must reside within a reasonable commuting distance from the posting locations 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 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-term disability benefits
Long-term disability benefits
401(k) with match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Overtime pay for associates working from a California location, based on California employment law