Nurse Case Manager I

Elevance Health

Nurse Case Manager I responsible for care management assessing and implementing care plans for members with complex health needs. Position operates in the field with some office attendance required.

Posted 5/27/2026full-timeGrand Prairie • Texas • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum.
Performs duties telephonically or on-site such as at hospitals for discharge planning.
Ensures member access to services appropriate to their health needs.
Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
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.

Requirements

What you’ll need

Requires 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 RN license in applicable state(s) required.
Multi-state licensure is required if this individual is providing services in multiple states.
Certification as a Case Manager is preferred.
For URAC accredited areas the following applies: Requires BA/BS and 3 years of clinical care experience; or any combination of education and experience, which would provide an equivalent background.
Current and active RN license required in applicable state(s).
Multi-state licensure is required if this individual is providing services in multiple states.
Certification as a Case Manager and a BS in a health or human services related field preferred.
Experience with home health is highly preferred.

Benefits

Comp & perks

Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs (unless covered by a collective bargaining agreement)
Medical, dental, vision, short and long term disability benefits
401(k) + match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

care managementclinical experienceassessmentscare plansauthorizationsreferralsdischarge planningproblem solvingnegotiationmonitoring and evaluation

Soft Skills

coordinationcommunicationinterpersonal skillsorganizational skills

Certifications

RN licenseCase Manager certification