Remote Telephonic Nurse Case Manager I – Care Coordination

Elevance Health; United States; Hybrid; USD 70,000 - 90,000; Full time

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager I to provide telephonic care management for members with complex and chronic needs. The role requires a GA RN license and may involve multi-state licensure, with in-person training sessions and a largely virtual workflow.

The position emphasizes assessments, care plan development, and coordination across internal and external resources to optimize health outcomes while maintaining compliance with licensure and benefits structures.

Qualifications

• Requires a BA/BS in a health-related field.
• 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted RN license from the State of Georgia required.
• Multistate licensure is required if this individual is providing services in multiple states.

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.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Skills

Communication

Care coordination

Multitasking

Typing while talking

Education

BA/BS in a health-related field

Tools

Microsoft Office

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager I to provide telephonic care management for members with complex and chronic needs. The role requires a GA RN license and may involve multi-state licensure, with in-person training sessions and a largely virtual workflow.

The position emphasizes assessments, care plan development, and coordination across internal and external resources to optimize health outcomes while maintaining compliance with licensure and benefits structures.