Telephonic Nurse Case Manager I

Telephonic Nurse Case Manager I Location: This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions. It provides maximum flexibility and autonomy, promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Alternate locations may be considered for candidates who 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. Work Schedule: Monday–Friday 8:30 am to 5:00 pm in your time zone, with 2–4 late shifts per month (11:30 am–8:00 pm EST). Multistate Licensure: This position will service members in different states; therefore multistate licensure is required. Responsibilities Ensures member access to services appropriate to their health needs. Conducts assessments to identify individual needs and develops a specific care management plan to address objectives and goals 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. Minimum Requirements Requires BA/BS in a health‑related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license in applicable state(s) required. Multi‑state licensure is required if this individual provides services in multiple states. Preferred Skills Certification as a Case Manager. Compensation: For virtual or in‑person candidates in the listed locations, the salary range for this position is $70,560 to $110,880. Locations: Colorado; New York; Illinois. Benefits Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase plan, and 401(k) contribution. All benefits are subject to eligibility requirements. Equal Employment Opportunity Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact View email address on click.appcast.io for assistance. Criminal Record Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Florida Screening Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration ( #J-18808-Ljbffr