Nurse Case Manager II

Nurse Case Manager II

The Elevance Health Companies, Inc. offers a virtual full‑time role available in several U.S. locations. This Nurse Case Manager II will coordinate complex member care across the continuum, working primarily by phone and occasionally onsite at hospitals.

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and establish a care management plan.
• Implements the plan, facilitates authorizations and referrals within the benefit structure or through external arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates the effectiveness of the care management plan and modifies it as necessary.
• Interfaces with Medical Directors and Physician Advisors on treatment plans.
• Negotiates reimbursement rates as applicable.
• Assists with problem solving related to providers, claims or service issues.
• Contributes to the development of utilization/care‑management policies and procedures.

• BA/BS in a health‑related field and at least 5 years of clinical experience (or equivalent combination of education and experience).
• Current, unrestricted RN license in applicable state(s).
• Multi‑state licensure required if working in multiple states.
• Case Manager certification preferred; experience in homecare or hospice preferred.

$79,000–$119,000 annually, depending on location, experience, and education.

Elevance Health is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including gender identity and expression), national origin, age, disability, veteran status, or any other status protected by law. Applicants requiring accommodation for the application process may contact elevancehealthj