Hybrid Nurse Case Manager II – Care Coordination

The Elevance Health Companies, Inc.; Rocky Hill (CT); Hybrid; USD 85,000 - 110,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager II to collaborate with healthcare providers to drive personalized health management for members with complex needs. The role emphasizes in-office and virtual work, with hybrid scheduling and multi-state licensure as needed.

The position requires a valid RN license, 3+ years of acute care experience, and potential certification in case management. Prior managed care exposure and knowledge of medical management improve candidacy.

Qualifications

• Requires HS diploma or equivalent with 3+ years acute care clinical experience.
• Current, valid RN license in applicable state; multi-state licensure may be required.
• Experience in nurse case management or discharge planning preferred.

Responsibilities

• Assess medical necessity of inpatient admissions, outpatient services, and appropriateness of setting and level of care.
• Collaborate with physicians to interpret appropriateness of care and plan interventions.
• Assess consumer needs for early discharge planning and develop care plans.
• Develop, implement, and coordinate individualized care plans.
• Monitor and adjust care management plans for effectiveness.
• Contribute to development of utilization/care management policies and procedures.
• Participate in intradepartmental teams and projects.

Skills

AS/BS in nursing

Case Manager certification

Managed care experience

Knowledge of medical management

Rural health knowledge

Education

HS diploma or equivalent

Job description

Elevance Health is seeking a Nurse Case Manager II to collaborate with healthcare providers to drive personalized health management for members with complex needs. The role emphasizes in-office and virtual work, with hybrid scheduling and multi-state licensure as needed.

The position requires a valid RN license, 3+ years of acute care experience, and potential certification in case management. Prior managed care exposure and knowledge of medical management improve candidacy.