Remote Nurse Case Manager I | Flexible Hybrid Schedule

The Elevance Health Companies, Inc.; St. Louis (MO); Remote; USD 60,000 - 90,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager I to perform telephonic and on-site care management for members with complex needs. The role supports discharge planning and requires licensure and clinical experience.

This position emphasizes collaboration with medical directors and internal resources. The organization operates a Hybrid Workforce Strategy with in-person requirements and remote work options, depending on location and policy.

Qualifications

• Requires BA/BS in a health related field and minimum of 3 years of clinical experience.
• Current, unrestricted RN license in applicable state(s) required.
• Multi-state licensure is required if providing services in multiple states.
• Certification as a Case Manager and BS in a health or human services related field preferred.

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.
• Implements care plan by 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 Physician Advisors on the development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.

Skills

Care coordination

Assessment skills

Telephonic service

Education

BA/BS in health-related field

Job description

Elevance Health is seeking a Nurse Case Manager I to perform telephonic and on-site care management for members with complex needs. The role supports discharge planning and requires licensure and clinical experience.

This position emphasizes collaboration with medical directors and internal resources. The organization operates a Hybrid Workforce Strategy with in-person requirements and remote work options, depending on location and policy.