Telephonic Nurse Case Manager II | Location: MST/PST. This role enables associates to work virtually full-time, providing flexibility and autonomy, with essential onboarding and skill development conducted in person as needed. Hours are Monday–Friday, 9:00 AM–5:30 PM (MST/PST), with two evening shifts weekly from 11:30 AM–8:00 PM (in the employee's time zone).
Note: Candidates outside a reasonable commuting distance from posting location will not be considered unless an accommodation is granted as required by law.
Responsibilities- The Telephonic Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs, by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Duties are performed telephonically.
- Ensure member access to services appropriate to their health needs.
- Conduct assessments to identify individual needs and develop a specific care management plan to address objectives and goals identified during assessment.
- Assist in facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
- Coordinate internal and external resources to meet identified needs.
- Monitor and evaluate effectiveness of the care management plan and modify as necessary.
- Interface with Medical Directors and other health professionals on the development of care management treatment plans.
- Assist in problem solving with providers, claims or service issues.
- Assist with development of utilization/care management policies and procedures.
- Requires a BS in a health-related field and a minimum of 5 years of nursing clinical experience.
- Current, unrestricted RN license is required.
- Multi-state licensure will be required, as individuals will be providing services in multiple states.
- Experience with the Microsoft Office suite and/or the ability to learn new computer programs/systems/software quickly.
- Ability to talk and type at the same time (telephonic/virtual communication).
- Background in an acute care setting (e.g., hospital/ED/ICU/med-surg).
- Telephonic and/or virtual nursing experience, preferred.
- Managed Care experience, preferred.
- Certification as a Case Manager, preferred.
- Minimum 2 years’ experience in acute care setting.
The salary range for candidates working in person or virtually in the locations below is $79,464 to $124,872. Location(s): Colorado, Illinois, Minnesota, Nevada.
In addition to salary, Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (subject to eligibility requirements).
The salary offered is based on factors set by the Company and is described in the posting with consideration for geographic location, work experience, education, and skill level. No wages or compensation are earned until conditions of the applicable policies and plans are met. Bonus, benefits, or other compensation are at the Company’s sole discretion unless required by law.
Company Information and PoliciesElevance Health is an Equal Employment Opportunity employer. Applicants who require accommodation to participate in the job application process may contact for assistance. Prospective employees may be screened under applicable laws. Vaccination policies may apply to certain patient/member-facing roles, as required by law. Elevance Health operates in a Hybrid Workforce Strategy, with time onsite communicated during the hiring process.
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