Telephonic RN Nurse Case Manager I

Elevance Health

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

Posted 9/23/2026full-timeUnited StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care management for members with complex and chronic needs, including the development and implementation of care plans, coordination of services, and effective communication with healthcare professionals. Holds a current RN license and possesses critical thinking skills essential for assessing and addressing individual member needs.

Highest-signal resume keywords

RN LicenseClinical Case ManagementUtilization ReviewCare Plan DevelopmentMicrosoft Office

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care ManagementAssessmentCare Plan ImplementationDischarge PlanningAuthorization FacilitationCritical ThinkingCoordination of ResourcesMonitoring and EvaluationTelephonic CommunicationEmail Management

Soft Skills

CollaborationCommunicationTeamwork

Certifications & Qualifications

Compact RN License

Industry Keywords

Chronic CareHealthcarePatient CareInpatient SettingOutpatient Setting

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 duties telephonically or on-site, including at hospitals for discharge planning
Ensure members understand benefits and assist with access to appropriate services
Conduct assessments to identify individual needs and create care management plans
Implement care plans through education and facilitation of authorizations/referrals
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 other health professionals on treatment plans
Assist members and providers with access to care, vendors, claims, and service issues

Requirements

What you’ll need

BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background
Current, unrestricted compact RN license in your home state
Multi-state licensure is required if providing services in multiple states
Previous experience with utilization review and/or prior authorization preferred
Clinical case management experience in an inpatient or outpatient setting preferred
Ability to talk, type and critically think 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
Excellent collaboration, communication and teamwork skills
Ability to work Monday through Friday, 8 am to 5 pm local time
Candidates must be within a reasonable commuting distance from the posting location(s), 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 an acceptable explanation is provided

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 arrangement, with required in-person training sessions
Work-life integration support