Nurse Case Manager I

The Elevance Health Companies, Inc.; Indianapolis (IN); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

merit increases

paid holidays

Paid Time Off

incentive bonus programs

medical

dental

vision

short and long term disability

401(k) +match

stock purchase plan

life insurance

wellness programs

financial education resources

Job summary

Elevance Health seeks a Nurse Case Manager I to assess, plan and coordinate care for members with complex needs. The role supports telephonic or on-site care management, including discharge planning and authorizations within the benefits structure.

Strong collaboration with medical directors and providers is essential. Requirements include a BA/BS in a health field, an active RN license, and multi-state licensure as applicable.

Qualifications

• Requires BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience providing equivalent background.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if providing services in multiple states.
• Certification as a Case Manager is preferred.
• Experience with utilization review and/or prior authorization.
• Clinical case management experience in inpatient or outpatient settings.

Responsibilities

• Assess, develop, implement and coordinate care plans for members with complex and chronic needs.
• Perform care management duties telephonically or on-site (e.g., discharge planning).
• Coordinate authorizations/referrals within benefits structure or via extra-contractual arrangements.
• Collaborate with Medical Directors and Physician Advisors on care plans.
• Monitor, evaluate and adjust care plans to optimize health outcomes.
• Communicate effectively with providers, claims teams and members.

Skills

Critical thinking

Communication

Teamwork

Time management

Education

BA/BS in health related field

RN license (unrestricted)

Multi-state licensure

Tools

Microsoft Office

Job description

Anticipated End Date

2026-11-07

Position Title

Nurse Case Manager I

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. 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. Alternate locations may be considered. AmeriBen is a proud member of the Elevance Health family of companies. We are a third-party administrator (TPA) of medical benefits, also providing medical management, human resource consulting and retirement benefits administration services.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The 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 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

• 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.

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 is providing services in multiple states.

Preferred Qualifications

• Certification as a Case Manager is preferred.
• Previous experience with utilization review and/or prior authorization.
• Clinical case management experience in an inpatient or outpatient setting.
• Ability to talk, type and critically think at the same time.
• Demonstrates critical thinking skills when interacting with members.
• 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.
• Excellent collaboration, communication and teamwork skills.

Job Level

Non-Management Exempt

Workshift

1st Shift (United States of America)

Job Family

MED > Licensed Nurse

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs (unless covered by a collective bargaining agreement)
• medical
• dental
• vision
• short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources

Accessibility Accommodation

Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact.

Vaccination Requirement

We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation.

Application Policy

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.

Please visit the Contract Worker Community Page.

Equal Employment Opportunity Statements

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.

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.

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.

Elevance Health is an Equal Opportunity Employer/Disability/Veterans.