Remote Telephonic Nurse Case Manager II

Elevance Health; Wilmington (DE); Remote; USD 85,000 - 115,000; Full time

Job summary

Elevance Health is seeking a Telephonic Nurse Case Manager II to coordinate care for members with complex needs via telephone, enabling virtual work with mandatory in-person trainings as required. Candidates must hold an RN license and have clinical experience.

The role focuses on assessing needs, developing and monitoring care plans, and coordinating approvals, referrals, and resources across the care continuum. Strong MS Office skills are preferred.

Qualifications

• Requires BA/BS in a health-related field.
• Current, unrestricted RN license in applicable state(s).
• Multi-state licensure is required if providing services in multiple states.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify needs and develops a care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits or extra-contractual arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care plan and adjusts as needed.
• Interfaces with Medical Directors and Physician Advisors on care plans.
• Assists in problem solving with providers.
• Assists with development of utilization/care management policies and procedures.

Skills

Telephonic case management

Case Manager Certification

Critical thinking

MS Office proficiency

Education

BA/BS in health-related field

RN license in applicable state(s)

Multi-state licensure

Tools

Microsoft 365

Job description

Elevance Health is seeking a Telephonic Nurse Case Manager II to coordinate care for members with complex needs via telephone, enabling virtual work with mandatory in-person trainings as required. Candidates must hold an RN license and have clinical experience.

The role focuses on assessing needs, developing and monitoring care plans, and coordinating approvals, referrals, and resources across the care continuum. Strong MS Office skills are preferred.