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Nurse Case Manager I
Elevance HealthTelephonic Nurse Case Manager I providing care management for complex health needs. Requires RN license and 3 years clinical experience, focusing on care plan development and evaluation.
Posted 5/27/2026full-timeSt. Louis • Florida, Kentucky, Montana, Texas • 🇺🇸 United StatesMid-LevelSeniorWebsite
About the role
Key responsibilities & impact- Telephonic Nurse Case Manager I is responsible for performing care management within the scope of licensure for members with complex and chronic care needs
- assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum
- Performs duties telephonically 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
- minimum of 3 years of clinical experience
- Current, unrestricted RN license in applicable state(s) required
- Multi-state licensure is required if providing services in multiple states
- Case Management experience is preferred
- minimum 2 years’ experience in acute care setting is preferred
- Managed Care experience is preferred
- Ability to talk and type at the same time is preferred
- Demonstrate critical thinking skills when interacting with members is preferred
- Experience with Microsoft Office and/or ability to learn new computer programs/systems/software quickly is preferred
- Ability to manage, review and respond to emails/instant messages in a timely fashion is preferred.
Benefits
Comp & perks- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical benefits
- dental benefits
- vision benefits
- short and long term disability benefits
- 401(k) + match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
care managementclinical experiencecase managementacute carecritical thinking
Soft Skills
problem solvingcommunicationnegotiationcoordination
Certifications
RN licensemulti-state licensure