Telephonic Nurse Case Manager I

Elevance Health

Telephonic Nurse Case Manager I at Elevance Health responsible for managing complex care needs. Ensures member access to services appropriate to their health needs through assessments and care planning.

Posted 6/11/2026full-timeAtlanta • 🇺🇸 United StatesMid-LevelSeniorWebsite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

clinical experiencecare managementassessmentsutilization managementproblem solvingtreatment plansauthorizationsreferralspolicy developmentcritical thinking

Soft Skills

communicationcoordinationevaluationadaptabilitytime management

Tools & Technologies

Microsoft Officecomputer programssoftware systems

Certifications & Qualifications

RN licenseCase Manager certification

Industry Keywords

health-related fieldcare management planmultistate licensurebenefits structureinternal and external resources

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 Advisor's on the development of care management treatment plans
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 a BA/BS in a health-related field
3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background
Current, unrestricted RN license from the State of Georgia required
Multistate licensure is required if this individual is providing services in multiple states
Ability to talk and type at the same time
Certification as a Case Manager
Demonstrate critical thinking skills
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

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