Nurse Case Manager II

Elevance Health

Telephonic Nurse Case Manager coordinating complex and chronic care for Elevance Health members. Assessing needs, implementing care plans, and coordinating authorizations, referrals, and healthcare resources.

Posted 8/5/2026full-timeDenver • Colorado, Nevada, Washington • 🇺🇸 United StatesMid-LevelSenior💰 $79,464 - $130,548 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care management for members with complex health needs, including the development and implementation of individualized care plans, coordination of resources, and effective communication with medical professionals. Holds a current RN license and possesses strong critical thinking and case management skills.

Highest-signal resume keywords

RN LicenseCase Management ExperienceCare Plan DevelopmentManaged Care ExperienceCritical Thinking Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care ManagementIndividualized Care PlansUtilization ManagementReimbursement NegotiationAcute Care ExperienceTelephonic CommunicationMicrosoft Office ProficiencyEmail Management

Soft Skills

Interpersonal CommunicationProblem SolvingAdaptability

Certifications & Qualifications

Case Manager Certification

Industry Keywords

Chronic Care ManagementHealth Needs AssessmentMulti-State LicensureProvider RelationsUtilization Policies

About the role

Key responsibilities & impact

Manage care for members with complex and chronic care needs within the scope of licensure
Assess members and develop individualized care management plans
Implement care plans by facilitating authorizations and referrals
Coordinate internal and external resources to meet identified member needs
Monitor and evaluate care plan effectiveness and modify plans as necessary
Interface with Medical Directors and Physician Advisors on treatment plans
Negotiate reimbursement rates when applicable
Help resolve provider, claims, or service issues
Assist with development of utilization and care management policies and procedures
Perform duties telephonically
Ensure member access to services appropriate to their health needs

Requirements

What you’ll need

BA/BS in a health-related field and minimum of 5 years of clinical experience, or an equivalent combination of education and experience
Current, unrestricted RN license in applicable state(s) required
Multi-state licensure required when providing services in multiple states
Case management experience preferred
Case Manager certification preferred
Minimum 2 years’ experience in an acute care setting preferred
Managed care experience preferred
Ability to talk and type simultaneously preferred
Critical thinking skills when interacting with members preferred
Experience with Microsoft Office and/or ability to learn new computer programs, systems, and software quickly preferred
Ability to manage, review, and respond to emails/instant messages promptly preferred
Ability to work Monday–Friday, 9:00 a.m.–5:30 p.m., with 1–2 late evenings from 11:30 a.m.–8:00 p.m., depending on time zone
COVID-19 and Influenza vaccination required for certain patient/member-facing roles unless an acceptable explanation is provided

Benefits

Comp & perks

$2000 sign-on bonus
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401(k) contribution
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) with match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Virtual full-time work arrangement, except for required in-person training sessions