Senior Nurse Case Manager (RN) - Virtual

Elevance Health; Sacramento (CA); Remote; USD 79,000 - 131,000; Full time

Benefits offered by this job

comprehensive benefits package

401(k) + match

paid holidays

Paid Time Off

incentive bonus programs

medical, dental, vision coverage

Job summary

Elevance Health is seeking a Nurse Case Manager II (RN) to oversee member care and ensure access to appropriate health services, including assessments and care plan coordination. This remote role supports virtual/telephonic interactions and regional flexibility within the U.S.

The position requires an active RN license (California preferred) and at least five years in clinical roles, with multi-state licensure upon hire.

Qualifications

• Requires BA/BS in a health related field.
• Minimum of 5 years of clinical experience; or any combination of education and experience providing equivalent background.
• Current, unrestricted RN license in applicable state(s) is required.
• Multi-state RN licensure is required for providing services in multiple states upon hire.
• Active California RN license is highly preferred.
• Experience with Microsoft Office and ability to learn new software quickly.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a care management plan.
• Assists in facilitating authorizations/referrals 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 other health professionals on care plans.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Skills

RN license

Clinical experience

Communication skills

Telephonic/virtual nursing

Education

BA/BS in health related field

Tools

Microsoft Office

Job description

Elevance Health is seeking a Nurse Case Manager II (RN) to oversee member care and ensure access to appropriate health services, including assessments and care plan coordination. This remote role supports virtual/telephonic interactions and regional flexibility within the U.S.

The position requires an active RN license (California preferred) and at least five years in clinical roles, with multi-state licensure upon hire.