Remote Nurse Care Manager I – Telephonic Case Management

Elevance Health, Inc.; United States; Remote; USD 38,000 - 72,000; Part time

Benefits offered by this job

401k

Health insurance

HSA

Job summary

Elevance Health, a leading health company, seeks a remote Case Manager with RN licensure to coordinate care for members with complex needs. The role supports discharge planning, uses telephonic care management, and requires multi-state licensure when crossing state lines. Strong computer skills and URAC considerations apply.

The position is 100% remote with a Mon–Fri 8am–5pm schedule. Contract role through BCForward, with housing and licensing considerations as noted in the posting.

Qualifications

• Requires HS diploma or equivalent and a minimum of 3 years of acute care clinical experience; or any combination of education and experience providing an equivalent background.
• Current, active valid unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if this individual is providing services in multiple states.
• AS or BS in nursing preferred.
• Certification as a Case Manager is preferred. For URAC accredited areas, current active RN license required in applicable state(s) that allows independent assessment within scope of practice.
• Requires 3 years full-time equivalent of direct clinical care experience; 5 years preferred or combination of education and experience; multi-state licensure if multiple states.
• Certification as a Case Manager or a BS in a health or human services related field also preferred.
• Computer experience a must.

Responsibilities

• Ensures medically appropriate, high-quality, cost-effective care by assessing inpatient admissions, extensions of stay, outpatient services, and appropriateness of care.
• Partners with physician reviewers and medical directors to interpret appropriateness of care and planning.
• Collaborates with providers to assess consumer needs for discharge planning.
• Conducts clinical assessment to develop goals addressed by a care plan.
• Monitors and evaluates effectiveness of the care plan and makes modifications as needed.

Skills

RN license

Multi-state licensure

Computer skills

Education

HS diploma or equivalent

AS or BS in nursing preferred

Case Manager Certification preferred

Tools

EMR systems

Job description

Elevance Health, a leading health company, seeks a remote Case Manager with RN licensure to coordinate care for members with complex needs. The role supports discharge planning, uses telephonic care management, and requires multi-state licensure when crossing state lines. Strong computer skills and URAC considerations apply.

The position is 100% remote with a Mon–Fri 8am–5pm schedule. Contract role through BCForward, with housing and licensing considerations as noted in the posting.