Remote Telephonic Nurse Case Manager II

Elevance Health; Latham (NY); Hybrid; USD 76,000 - 119,000; Full time

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager II to manage care for members with complex needs. This remote/hybrid role requires a current RN license and multi-state licensure, with in-person training as needed. Expect telephonic assessments, care plan development, and coordination across providers.

The position emphasizes collaboration with medical directors and timely communication, supporting members across states with a strong pay range and comprehensive benefits.

Qualifications

• Requires BA/BS in a health-related field and minimum of 5 years of clinical experience.
• Current, unrestricted RN license in applicable state required.
• Multi-state licensure is required if this individual is providing services in multiple states.
• Experience with case management and certifications is preferred.

Responsibilities

• Assess members telephonically to determine care needs.
• Develop and coordinate individualized care plans.
• Facilitate authorizations/referrals within benefits or extra-contractual arrangements.
• Coordinate internal and external resources for member needs.
• Monitor and evaluate care plan effectiveness and adjust as needed.
• Collaborate with Medical Directors and Physician Advisors on treatment plans.
• Negotiate rates of reimbursement where applicable.
• Assist with problem solving for providers and claims.
• Contribute to utilization/care management policy development.

Skills

Case management experience

Certification as a Case Manager

Acute care experience

Microsoft Office proficiency

Timely email/IM communication

Education

BA/BS in health-related field

RN license (unrestricted)

Multi-state licensure

Tools

Microsoft Office

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager II to manage care for members with complex needs. This remote/hybrid role requires a current RN license and multi-state licensure, with in-person training as needed. Expect telephonic assessments, care plan development, and coordination across providers.

The position emphasizes collaboration with medical directors and timely communication, supporting members across states with a strong pay range and comprehensive benefits.