Nurse Case Manager II

Elevance Health

Nurse Case Manager II managing telephonic care for members with complex health needs. Overseeing care plans and collaborating with healthcare professionals to optimize member care.

Posted 5/27/2026full-timeTampa • Florida, Kentucky, Montana, Texas • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

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.
Assists with development of utilization/care management policies and procedures.

Requirements

What you’ll need

Requires BA/BS in a health related field and minimum of 5 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 preferred.
BS in a health related field is preferred.
Ability to talk and type at the same time preferred.
Demonstrate critical thinking skills when interacting with members preferred.
Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly preferred.
Ability to manage, review and respond to emails/instant messages in a timely fashion preferred.
Minimum 2 years’ experience in acute care setting preferred.
Minimum 2 years’ "telephonic" Case Management experience with a Managed Care Company preferred.
Managed Care experience preferred.

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

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

clinical experiencecare managementutilization managementnegotiationassessmentproblem solvingcritical thinkingtelephonic case managementmanaged care

Soft Skills

communicationinterpersonal skillsorganizational skillstime management

Certifications

RN licenseCase Manager certification