Telephonic Nurse Case Manager II
Elevance Health
Posted: 10/21/2026
Senior Manager, Corporate Accounts
Johnson & Johnson
Posted: 10/21/2026
Senior Manager, Creator Commerce – TikTok Shop, Trybe
Athletic Greens
Posted: 10/21/2026
Experience Manager
Maverick Collective
Posted: 10/21/2026
Field Reimbursement Manager, Immunology, Dermatology
AbbVie
Posted: 10/21/2026Field Reimbursement Manager, Oncology
AbbVie
Posted: 10/21/2026Field Reimbursement Manager, Oncology
AbbVie
Posted: 10/21/2026Field Reimbursement Manager, Oncology
AbbVie
Posted: 10/21/2026Field Reimbursement Manager, Oncology
AbbVie
Posted: 10/21/2026
Senior LTSS Service Care Manager, RN
Centene Corporation
Posted: 10/21/2026
Manager, Member Engagement
First Book
Posted: 10/21/2026Cloud
Credit Strategy & Decisioning Manager
GoodLeap
Posted: 10/21/2026PythonSQLTableau
Senior Manager, Site Optimization
Paula's Choice Skincare
Posted: 10/21/2026Tableau
Manager, Neurosciences
Sutter Health
Posted: 10/21/2026
UAT and Production Validation Manager, Merchant Services Product
Wells Fargo
Posted: 10/21/2026Branch Manager
Wells Fargo
Posted: 10/21/2026Branch Manager
Wells Fargo
Posted: 10/21/2026Branch Manager
Wells Fargo
Posted: 10/21/2026
Senior Manager, Source to Pay Technology
Boeing
Posted: 10/21/2026ERP
Facilities Manager
Uline
Posted: 10/21/2026Warehouse Department Manager
Uline
Posted: 10/21/2026Telephonic Nurse Case Manager II
Elevance HealthPosted 10/21/2026full-timeWoodland Hills • California • United StatesMid-LevelSenior💰 $40 - $66 per hourWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in telephonic care management, developing and implementing individualized care plans, and coordinating resources to meet complex health needs. Holds a current RN license and possesses strong critical thinking and communication skills to effectively interact with members and healthcare professionals.
Highest-signal resume keywords
RN LicenseCase Management ExperienceManaged Care ExperienceCritical Thinking SkillsMicrosoft Office Proficiency
About the role
Key responsibilities & impact- Perform telephonic care management for members with complex and chronic care needs
- Assess members and develop individualized care management plans
- Implement care plans through authorizations and referrals within benefit structures or extra-contractual arrangements
- Coordinate internal and external resources to meet identified needs
- Monitor and evaluate care plan effectiveness and modify plans as necessary
- Ensure member access to appropriate health services
- Interface with Medical Directors and Physician Advisors on care management treatment plans
- Negotiate reimbursement rates as applicable
- Assist with provider, claims, and service issue problem solving
- Assist with developing utilization and care management policies and procedures
- Service members in different states
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 California 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, and software quickly preferred
- Ability to manage, review, and respond to emails/instant messages in a timely fashion preferred
- Monday–Friday availability, 9:00am–5:30pm, with 1–2 late evenings from 11:30am–8:00pm depending on time zone
- Required in-person training sessions
- Candidates must be within a reasonable commuting distance from the posting location(s), unless an accommodation is granted
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
- Virtual work flexibility
- Professional and personal 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
Telephonic Care ManagementIndividualized Care PlansCare Plan ImplementationReimbursement NegotiationUtilization Management PoliciesAcute Care ExperienceMulti-State LicensureProblem SolvingMember Access CoordinationCare Plan Monitoring
Soft Skills
Communication SkillsInterpersonal SkillsTime ManagementAdaptabilityTeam Collaboration
Tools & Technologies
Microsoft OfficeComputer ProgramsHealthcare SystemsEmail ManagementInstant Messaging
Certifications & Qualifications
Case Manager Certification
Industry Keywords
Chronic Care ManagementHealth Services AccessClinical ExperienceCare Management Treatment PlansProvider Relations