Telephonic Nurse Case Manager II

Anticipated End Date 2026-10-21 Position Title Telephonic Nurse Case Manager II Job Description Telephonic Nurse Case Manager II Location This role enables associates to work virtually full-time, with the exception of required in-person training sessions, 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 Monday-Friday 8:30am to 5:00pm in your time zone, with 2-4 late shifts per month (11:30 AM-8:00 PM EST). Licensure This position will service members in different states; therefore, Multi-State Licensure will be required. Responsibilities 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. 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. Assists with development of utilization/care management policies and procedures. Minimum Requirements Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in applicable state required. Multi-state licensure is required if this individual is providing services in multiple states. Preferred Capabilities, Skills and Experiences Case Management experience. Certification as a Case Manager. Minimum 2 years' experience in acute care setting. Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly. Ability to manage, review and respond to emails/instant messages in a timely fashion. Salary 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 Benefits comprehensive benefits package incentive and recognition programs equity stock purchase 401k contribution (all benefits are subject to eligibility requirements) The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level Non-Management Exempt Job Family MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communiti #J-18808-Ljbffr Elevance Health (Anthem)