Telephonic Nurse Case Manager, II

Elevance Health

. Provide telephonic care management for members with complex and chronic care needs within scope of licensure .

Posted 10/12/2026full-timeRemote • United StatesMid-LevelSenior💰 $75,680 - $119,196 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in telephonic care management, including the development and implementation of individualized care plans for members with complex and chronic needs. Proficient in case management, critical thinking, and effective communication with healthcare professionals to ensure optimal member access to health services.

Highest-signal resume keywords

RN LicenseCase Management ExperienceManaged Care ExperienceMulti-State LicensureCertification as a Case Manager

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Telephonic Care ManagementIndividualized Care PlansCritical ThinkingNegotiation SkillsUtilization Management

Soft Skills

Problem-SolvingCommunication SkillsTime Management

Tools & Technologies

Microsoft OfficeComputer ProgramsHealthcare Software

Certifications & Qualifications

Certification as a Case Manager

Industry Keywords

Chronic Care ManagementAcute Care SettingHealth Services AccessReimbursement NegotiationCare Management Policies

About the role

Key responsibilities & impact

Provide telephonic care management for members with complex and chronic care needs within scope of licensure
Assess member needs and develop individualized care management plans
Implement care plans by facilitating authorizations and referrals within benefits structures 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 treatment plans
Ensure member access to appropriate health services
Negotiate reimbursement rates as applicable
Assist with provider, claims, or service issue problem-solving
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 required
Multi-state licensure required when providing services in multiple states
Case Management experience
Certification as a Case Manager
Minimum 2 years’ experience in acute care setting
Managed Care experience
Ability to talk and type at the same time
Critical thinking skills when interacting with members
Experience with Microsoft Office and/or ability to learn new computer programs, systems, and software quickly
Ability to manage, review and respond to emails/instant messages in a timely fashion
Must complete the online pre-employment skills assessment within 48 hours of receipt and meet the criteria
Must reside within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law
Ability to work Monday–Friday 9:00am–5:30pm EST and one late evening 11:30am–8:00pm EST
Multi-State Licensure required to service members in different states

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
Required in-person training sessions
COVID-19 and Influenza vaccination support/requirement for certain roles