Nurse Case Mgr II (RN)

Elevance Health; Sacramento (CA); A distancia; USD 79.000 - 131.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

comprehensive benefits package

401(k) + match

paid holidays

Paid Time Off

incentive bonus programs

medical, dental, vision coverage

Descripción de la vacante

Elevance Health is seeking a Nurse Case Manager II (RN) to oversee member care and ensure access to appropriate health services, including assessments and care plan coordination. This remote role supports virtual/telephonic interactions and regional flexibility within the U.S.

The position requires an active RN license (California preferred) and at least five years in clinical roles, with multi-state licensure upon hire.

Formación

• Requires BA/BS in a health related field.
• Minimum of 5 years of clinical experience; or any combination of education and experience providing equivalent background.
• Current, unrestricted RN license in applicable state(s) is required.
• Multi-state RN licensure is required for providing services in multiple states upon hire.
• Active California RN license is highly preferred.
• Experience with Microsoft Office and ability to learn new software quickly.

Responsabilidades

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a care management plan.
• Assists in facilitating authorizations/referrals 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 other health professionals on care plans.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Conocimientos

RN license

Clinical experience

Communication skills

Telephonic/virtual nursing

Educación

BA/BS in health related field

Herramientas

Microsoft Office

Descripción del empleo

Nurse Case Mgr II (RN)

Anticipated End Date: 2026-10-27

Location

Virtual

Work Shift

Monday – Friday, 9:00 am to 5:30 pm (PST or MST) with 2 evening shifts every week from 11:30 am to 8:00 pm (PST or MST)

Responsibilities

• 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.
• Assists in 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 other health professionals on the development of care management treatment plans.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Minimum Requirements

• Requires BA/BS in a health related field
• Minimum of 5 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) is required.
• Multi‑state RN licensure is required for providing services in multiple states upon hire.

Preferred Skills, Capabilities and Experiences

• Active California RN license is highly preferred.
• Minimum 2 years of direct Case Management experience.
• Certification as a Case Manager, CCM is preferred.
• Telephonic and/or virtual nursing experience.
• Managed Care experience.
• Minimum 2 years’ experience in acute care setting.
• Experience with (Microsoft Office suite) and/or ability to learn new computer programs/systems/software quickly.
• Ability to speak and type at the same time.

Salary

For candidates working in person or virtually in the below locations, the salary range for this specific position is $79,464 to $130,548.

*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.

Locations

California, Colorado, Nevada, Washington

Benefits

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

Job Information

Job Level: Non-Management Exempt

Workshift: 1st Shift (United States of America)

Job Family: MED > Licensed Nurse

Resume Acceptance Policy

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.

Company

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.

Hybrid Work Policy

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.

Vaccination Policy

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.

EEO Statement

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

Accessibility Accommodation Request Form

Florida Fair Chance Information

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Postal Note

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.