Nurse Case Mgr II (RN)

Elevance Health; San Francisco (CA); Remote; USD 79,000 - 131,000; Full time

Benefits offered by this job

Benefits package

Incentive programs

Stock purchase plan

401(k) contribution

Job summary

Elevance Health is seeking a Nurse Case Mgr II (RN) for a fully virtual role serving members across multiple states. Requires BA/BS in a health-related field, a current RN license, and multi-state licensure eligibility; telephonic case management experience is essential.

The role focuses on screening, assessing, planning, coordinating, and evaluating care for members with complex needs, with occasional in-person sessions and a strong emphasis on care continuity and collaboration with medical

Qualifications

• BA/BS in a health-related field and 5+ years of clinical experience.
• Current, unrestricted RN license; multi-state licensure required for multi-state service.
• Telephonic care management and analysis to optimize member health.
• Coordinate authorizations/referrals within benefits structure.
• Engage with Medical Directors and other health professionals.
• Outbound telephonic case management program.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a care plan.
• Assists in facilitating authorizations/referrals as appropriate.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care plan.
• Interacts with Medical Directors on care management plans.

Skills

California RN license

Case management

CCM certification

Telephonic nursing

Managed care

Acute care experience

MS Office

Education

BA/BS in health-related field

RN license

Multi-state licensure

Job description

Anticipated End Date

2026-10-27

Position Title

Nurse Case Mgr II (RN)

Nurse Case Mgr II (RN)Anticipated Job Posting End Date: 10/26/2026*This position will service members in different states: Multi-State RN Licensure will be required upon hire.Location: Virtual- This role enables associates to work virtually full-time, except for 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 a commuting distance from an officePlease 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. 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)The Nurse Case Mgr II (RN) is responsible for care management within the scope of licensure for members with complex and chronic care needs. Care management is conducted through screening, assessing, stratifying risk, planning, implementing (care coordination), following up, transitioning (transitional care), communicating post transition, and evaluating members. Our care model is designed to optimize member health care across the care continuum. We provide meaningful interventions that drive improvements in clinical outcomes, productivity, and quality of life. This is an outbound calling program, 100% telephonic.

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.
• 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 and 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.

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

Location(s): California, Colorado, Nevada, Washington

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 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.

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