Job Description

Telephonic Nurse Case Manager I Location: • Works virtually full‑time with required in‑person training sessions. • Alternate locations considered if within commuting distance of an office. • Work schedule Monday–Friday during standard business hours in your time zone, with 2–4 late shifts per month (11:30 AM–8:00 PM ET). • Multi‑State licensure is required to service members in multiple states. The Telephonic Nurse Case Manager I is responsible for performing 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 remotely. Responsibilities Ensures member access to services appropriate to their health needs. Conducts assessments to identify individual needs and develop a care management plan to address objectives and goals. 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. Negotiate rates of reimbursement, as applicable. Assists in problem solving with providers, claims or service issues. Minimum Requirements BA/BS in a health‑related field and a minimum of 3 years of clinical experience; or equivalent combination of education and experience. Current unrestricted RN license in applicable state(s). Multi‑state licensure if services are provided in multiple states. Preferred Capabilities, Skills and Experiences Certification as a Case Manager. Salary & Benefits Salary range: $70,560 to $110,880 (dependent on state, experience, and education). Locations: Colorado; New York; Illinois. Benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase, 401(k) contribution, medical, dental, vision, disability, life insurance, wellness programs, and financial education resources. 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 elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. 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 Elevance Health

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