Remote RN Case Manager II — Care Planning & Coordination

Elevance Health (Anthem); California; Hybrid; CAD 81,000 - 127,000; Full time

Benefits offered by this job

Comprehensive benefits

Equity stock purchase program

401k contribution

Job summary

Elevance Health is seeking a Nurse Case Manager II in California to assess members, develop tailored care plans, and coordinate authorizations, referrals, and resources across the care team. The role emphasizes collaboration with Medical Directors and Physician Advisors to optimize outcomes.

Candidates should hold a BA/BS in a health-related field, have 5+ years of clinical experience, and possess an active RN license.

Qualifications

• Requires BA/BS in a health-related field and 5+ years of clinical experience.
• Current, unrestricted RN license in applicable state(s).
• Multi-state licensure if providing services in multiple states.

Responsibilities

• Ensures member access to services appropriate to health needs.
• Conducts assessments and develops care plans to address objectives.
• Implements care plans via authorizations/referrals within benefits.
• Coordinates internal and external resources to meet needs.
• Monitors and evaluates care management effectiveness and updates plans.
• Interfaces with Medical Directors and Physician Advisors on care plans.
• Negotiates reimbursement rates where applicable.
• Assists with problem solving for providers, claims or service issues.
• Contributes to utilization/care management policy development.

Skills

RN license

Clinical experience

Case management

Education

BA/BS in health related field

Job description

Elevance Health is seeking a Nurse Case Manager II in California to assess members, develop tailored care plans, and coordinate authorizations, referrals, and resources across the care team. The role emphasizes collaboration with Medical Directors and Physician Advisors to optimize outcomes.

Candidates should hold a BA/BS in a health-related field, have 5+ years of clinical experience, and possess an active RN license.