Nurse Case Mgr

Elevance Health (Anthem); Boght Corners (NY); Hybrid; USD 76,000 - 125,000; Full time

Benefits offered by this job

Comprehensive benefits

Incentives & recognition

Equity stock purchase

401k contribution

Job summary

Elevance Health in New York is seeking a Nurse Case Manager II to provide telephonic care management for members with complex and chronic care needs, assessing, developing, implementing, coordinating, monitoring, and evaluating care plans across the care continuum. This hybrid role requires in-person training sessions and a current, unrestricted RN license (multi-state licensure preferred).

The position offers a comprehensive benefits package and a competitive salary, with emphasis on

Qualifications

• Current, unrestricted RN license in applicable state required.
• Multi-state licensure is required if services are rendered in multiple states.

Responsibilities

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify needs and develop a care management plan.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate care plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem solving with providers, claims or service issues.
• Assist with development of utilization/care management policies.

Skills

Case management

Utilization management

Case manager certification

Acute care experience

Microsoft Office

Email/IM management

Education

RN license

Multi-state licensure

Job description

Anticipated End Date: 2026-10-23

Position Title: Nurse Case Manager II

Hours: M-F 9:30 AM-6:30 PM EST

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 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.

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. Perform duties telephonically.

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.
• Implement 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.
• Assists with development of utilization/care management policies and procedures.

Minimum Requirements

• Current, unrestricted RN license in applicable state required.
• Multi-state licensure is required if this individual provides services in multiple states.

Preferred Capabilities, Skills and Experiences

• Case Management experience.
• Utilization 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.

This position will service members in different states; therefore, Multi-State Licensure will be required.

Salary and Location

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $75,680-$124,872

Location(s): NEW YORK

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

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). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* 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

Workshift

1st Shift (United States of America)

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 communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we