Nurse Case Manager II

About this role

• Nurse Case Manager II Anticipated job Posting End Date: 11/21/2026 This role enables associates to work virtually full-time, except for 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 accommodation is granted as required by law.
• Work Hours: Monday - Friday; 4 days a week 9AM - 5:30 PM; 1 day a week 11:30AM - 8PM (local time) The 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 or on-site such as at hospitals for discharge planning.
• How you will make an impact Primary duties may include, but are not limited to: 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(s) required.
• Multi-state licensure is required if this individual is providing services in multiple states.
• Preferred Skills, Capabilities and Experiences: Certification as a Case Manager and a BS in a health or human services related field preferred.
• Active Registered Nurse Compact License is highly preferred For candidates working in person or virtually in the below locations, the salary* range for this specific position is $75,680 to $124,872 Location(s): Colorado, Columbus, Ohio, 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).

Key skills & tools

View & apply

Links open in a new tab. jobhustl never applies on your behalf - you always go to the employer.