Nurse Case Mgr I (US)

The Elevance Health Companies, Inc.; St. Louis (MO); Remote; USD 70,000 - 95,000; Full time

Job summary

Elevance Health seeks a Nurse Case Manager I to manage care plans for members with complex and chronic needs, working primarily remotely with some in-person training. The role supports discharge planning and coordination across the care continuum.

Qualifying candidates will have an RN license, a health-related BA/BS, and multi-state licensure; case management certification and a related BS are preferred. The position emphasizes flexible scheduling and collaboration with Medical Directors.

Qualifications

• BA/BS in health-related field and minimum of 3 years clinical experience.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if this individual is providing services in multiple states.
• Certification as Case Manager and BS in health or human services preferred.

Responsibilities

• Assess, develop, implement, coordinate, monitor and evaluate care plans designed to optimize member health care across the care continuum.
• Perform care management duties telephonically or on-site (e.g., hospital discharge planning).
• Ensure member access to services appropriate to health needs and coordinate resources.

Skills

Care coordination

Client communication

Education

BA/BS in health-related field

RN license (unrestricted)

Multi-state licensure

Job description

Anticipated End Date: 2026-09-23 Position Title: Nurse Case Mgr I (US) Job Description: Nurse Case Manager I Work Schedule: M-F 10:30am-7:30pm CST 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 if candidates reside within a commuting distance from an office.

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 Skills and Capabilities:

• Certification as a Case Manager and a BS in a health or human services related field preferred.

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 serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and 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 and financial education resources, to name a few.

• 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

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 health of our associates and communities is a top priority for Elevance Health. 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. Elevance Health will also follow all relevant federal, state, and 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.

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. 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.

NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

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Fueled by our bold purpose to improve the health of humanity, we are transforming from a traditional health benefits organization into a lifetime trusted health partner.Our nearly 100,000 associates serve approximately 100M+ people, at every stage of health. We address a full range of needs with an integrated whole health approach, powered by industry-leading capabilities and a digital platform for health.

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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. 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.

Please visit the Contract Worker Community Page. Elevance Health is an Equal Opportunity Employer/Disability/Veterans.