Remote Nurse Case Manager – California HMO

Elevance Health

Cerritos (CA)

Hybrid

USD 74,000 - 121,000

Full time

4 hours ago

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Benefits offered by this job

Comprehensive benefits

Incentive programs

Equity stock purchase & 401k

Job summary

Elevance Health seeks a Nurse Case Manager I for California HMO to oversee care management for members with complex needs. The role blends telephonic casework with occasional in-person onboarding, coordinating care plans and authorizations across providers within the benefits structure.

The position requires a California RN license and a BA/BS in a health-related field with at least 3 years of clinical experience. Hybrid work with weekly onsite obligations is described.

Qualifications

Requires BA/BS in a health-related field and minimum of 3 years of clinical experience.
Current, unrestricted RN license in California.
Demonstrated ability to coordinate care plans and collaborate with providers.

Responsibilities

Assess, develop, implement, coordinate and evaluate care plans for members with complex needs.
Perform care management duties telephonically with medical groups, providers and members.
Facilitate authorizations/referrals within benefits or through arrangements and monitor outcomes.
Coordinate internal and external resources to meet identified needs and track effectiveness.
Interface with Medical Directors and Physician Advisors on treatment plans.

Skills

Case Manager experience

Clinical experience with chronicDiseas

Discharge planning

Education

BA/BS in health-related field

Job description

The position requires a California RN license and a BA/BS in a health-related field with at least 3 years of clinical experience. Hybrid work with weekly onsite obligations is described.

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