Nurse Case Manager I

Elevance Health

Nurse Case Manager I at Elevance Health managing care for members with complex chronic needs, coordinating and evaluating care plans for optimal health outcomes.

Posted 7/13/2026full-timeSeattle • Florida, Ohio, Washington • 🇺🇸 United StatesMid-LevelSenior💰 $70,560 - $100,800 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care management for members with complex and chronic care needs, including assessment, care plan development, and coordination of services. Proficient in telephonic case management and collaboration with medical professionals to optimize member health outcomes.

Highest-signal resume keywords

RN LicenseCare ManagementClinical ExperienceCase Management CertificationTelephonic Case Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care Plan DevelopmentAssessmentCare CoordinationMonitoring and EvaluationAuthorization FacilitationNegotiationProblem Solving

Soft Skills

Interpersonal CommunicationCollaboration

Certifications & Qualifications

Case Manager Certification

Industry Keywords

MCO ExperienceHospital Case ManagementMulti-State LicensureChronic Care Management

About the role

Key responsibilities & impact

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 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
minimum of 3 years of clinical experience
Current and active RN license required in applicable state(s)
Multi-state licensure is required if providing services in multiple states
Certification as a Case Manager is preferred
Previous MCO or Hospital Case Management experience is preferred
Telephonic case management experience preferred

Benefits

Comp & perks

comprehensive benefits package
incentive and recognition programs
equity stock purchase
401k contribution
merit increases
paid holidays
Paid Time Off
short and long term disability benefits
medical, dental, and vision benefits
wellness programs
financial education resources