Nurse Case Mgr II

The Elevance Health Companies, Inc.; Louisville (KY); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid time off

Incentive bonus programs

Medical coverage

Dental coverage

Vision coverage

Disability insurance

401(k) match

Stock purchase plan

Life insurance

Wellness programs

Financial education

Job summary

Elevance Health is seeking a Nurse Case Manager II to coordinate care for members with complex needs. The role is performed mainly by phone, with required in-person trainings and some hybrid/onsite components for select locations.

The position requires an active RN license in the applicable state and multi-state licensure as care is provided across states. Strong case management and utilization management experience are preferred in a dynamic health plan environment.

Qualifications

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

Responsibilities

• Assess, develop, implement, coordinate, monitor, and evaluate care plans for members with complex and chronic care needs.
• Perform duties telephonically to coordinate care across the continuum.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the effectiveness of the care plan and modify as needed.
• Interface with Medical Directors and Physician Advisors on care management plans; negotiate rates of reimbursement as applicable.

Skills

RN licensure

Multi-state licensure

Case management experience

Utilization management

Case manager certification

MS Office proficiency

Strong communication

Time management

Email/phone handling

Tools

Microsoft Office

Job description

Anticipated End Date: 2026-09-24 Position Title: Nurse Case Mgr II Job Description: Nurse Case Manager II Hours: M-F 9:30 AM-6:30 PM EST Virtual: 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.

Location(s): Illinois, Kentucky, Missouri, Virginia, Wisconsin, Ohio

Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: MED > Licensed Nurse

Benefits & Compensation

• 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 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.