Remote Nurse Case Manager I | Care Coordination

Elevance Health (Anthem); North Farms (CT); Remote; USD 71,000 - 111,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager I to support virtual work arrangements with occasional in-person onboarding. The role requires a nursing license and case management expertise to coordinate member care across settings.

The position emphasizes flexible locations with potential for hybrid attendance when needed and a strong focus on improving member outcomes and service efficiency.

Qualifications

• BA/BS in a health-related field with a minimum of 3 years of clinical experience.
• Current, unrestricted RN license; multi-state licensure required if practicing in multiple states.
• Certification as a Case Manager is preferred.

Responsibilities

• Ensure member access to services appropriate to health needs.
• Conduct assessments to identify needs and a care management plan.
• Implement care plans by facilitating authorizations/referrals within benefits or through extra-contractual arrangements.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the care management plan and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem solving with providers, claims or service issues.

Skills

RN license

Multistate licensure

Case management knowledge

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Nurse Case Manager I to support virtual work arrangements with occasional in-person onboarding. The role requires a nursing license and case management expertise to coordinate member care across settings.

The position emphasizes flexible locations with potential for hybrid attendance when needed and a strong focus on improving member outcomes and service efficiency.