Job Description

Telephonic Nurse Case Manager II

Telephonic Nurse Case Manager II

Location: This role enables associates to work virtually full-time, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Hours: MondayFriday 9:00 AM5:30 PM with two evening shifts each week from 11:30 AM8:00 PM (in your time zone).

*This position will service members in different states; therefore, Multi-State Licensure will be required.

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. Performs duties telephonically.

How you will make an 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.
• Assists in 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 other Health Professionals 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.

Minimum Requirements:

• Requires BS in a health-related field and 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.

Preferred Capabilities, Skills and Experiences:

• Experience with the Microsoft Office suite and/or the ability to learn new computer programs/systems/software quickly, preferred.
• Ability to talk and type at the same time, preferred.
• Background in an acute care setting (e.g., hospital/ED/ICU/med-surg), preferred.
• 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.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $75,680 to $119,196.

Location(s): New York, Virginia

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

Job Level: Non-Management Exempt

Workshift: Job Family: MED > Licensed Nurse

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