Telephonic Nurse Case Manager II
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Posted: 10/21/2026Telephonic Nurse 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 critical thinking and communication skills to effectively interact with members and healthcare providers.
Highest-signal resume keywords
RN LicenseCase Management ExperienceClinical ExperienceManaged Care ExperienceCritical Thinking Skills
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
- Ensure member access to services appropriate to health needs
- Conduct assessments to identify individual needs and care management 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, as applicable
- Assist with provider, claims, or service issue problem solving
- Assist with developing utilization and care management policies and procedures
- Perform duties telephonically
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 when providing services in multiple states
- Case Management experience preferred
- Certification as a Case Manager preferred
- Minimum 2 years’ experience in acute care setting preferred
- Managed Care experience preferred
- Ability to talk and type at the same time preferred
- Critical thinking skills when interacting with members preferred
- Experience with Microsoft Office and/or ability to learn new computer programs, systems, or software quickly preferred
- Ability to manage, review, and respond to emails/instant messages in a timely fashion preferred
- Ability to work Monday–Friday 9:00am–5:30pm with 1–2 late evenings, 11:30am–8:00pm depending on time zone
- Candidates must be within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law
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, except for required in-person training sessions
- Maximum flexibility and autonomy
- Professional growth opportunities
- COVID-19 and Influenza vaccination support/requirements for certain roles
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 DevelopmentAssessmentCare CoordinationUtilization ManagementReimbursement NegotiationProblem SolvingTelephonic Communication
Soft Skills
Communication SkillsInterpersonal SkillsTime Management
Tools & Technologies
Microsoft OfficeComputer Programs
Certifications & Qualifications
Case Manager Certification
Industry Keywords
Chronic Care ManagementAcute Care SettingHealth Related FieldMulti-State Licensure