Telephonic Nurse Case Manager II

Elevance Health

Telephonic Nurse Case Manager II ensuring member access to services and managing complex care needs. Responsible for assessments, care plan implementation, and coordination of resources.

Posted 5/7/2026full-timeAtlanta • Florida, New York • 🇺🇸 United StatesMid-LevelSenior💰 $79,464 - $119,196 per yearWebsite

About the role

Key responsibilities & impact

responsible for care management within the scope of licensure for members with complex and chronic care needs
assessing, developing, implementing, coordinating, monitoring, and evaluating care plans
ensures member access to services appropriate to their health needs
conducts assessments to identify individual needs and a specific care management plan
implements care plan by facilitating authorizations/referrals as appropriate within benefits structure
coordinates internal and external resources to meet identified needs
monitors and evaluates effectiveness of the care management plan and modifies as necessary
interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans
negotiates rates of reimbursement, as applicable
assists in problem solving with providers, claims or service issues
assists with development of utilization/care management policies and procedures

Requirements

What you’ll need

BA/BS in a health-related field
minimum of 5 years of clinical experience
current, unrestricted RN license in applicable state required
Multi-state licensure required if 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
Demonstrate critical thinking skills when interacting with members
Experience with Microsoft Office and/or ability to learn new computer programs/systems/software quickly
Ability to manage, review and respond to emails/instant messages in a timely fashion

Benefits

Comp & perks

comprehensive benefits package
incentive and recognition programs
equity stock purchase
401k contribution

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

care managementassessingdeveloping care plansimplementing care planscoordinating resourcesmonitoring care plansevaluating care plansnegotiating reimbursement ratesproblem solvingutilization management

Soft Skills

critical thinkingcommunicationinterpersonal skillsorganizational skillstime management

Certifications

RN licenseCase Manager certification