Telephonic Nurse Case Manager I

Elevance Health; Los Angeles (CA); Remote; USD 68,000 - 119,000; Full time

Job summary

A leading healthcare company is seeking a Telephonic Nurse Case Manager I to provide virtual care management. This role involves assessing member needs, developing care plans, and collaborating with healthcare providers. Candidates must have a health-related degree and RN license. The position offers flexibility and a comprehensive benefits package.

Benefits

Comprehensive benefits packages

Incentive programs

Stock purchase

401k contributions

Qualifications

• At least 3 years of clinical experience or equivalent.
• Current, unrestricted RN license in applicable state(s).
• Multistate licensure required.

Responsibilities

• Ensure member access to appropriate services based on health needs.
• Conduct assessments to identify needs and develop care management plans.
• Monitor and evaluate the effectiveness of care plans.

Skills

Critical thinking

Communication

Time management

Education

BA/BS in a health-related field

Tools

Microsoft Office

Job description

Anticipated End Date: 2025-05-29

Position Title: Telephonic Nurse Case Manager I

Job Description:

Telephonic Nurse Case Manager I

Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Work schedule: Monday - Friday 9:00am to 5:30pm with 1-2 late evenings 11:30am to 8:00pm depending on your time zone.

Additional notes: This position services members in different states; therefore, Multi-State Licensure is required. It also requires an online pre-employment skills assessment, which is free and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. The assessment must be completed within 48 hours of receipt.

Responsibilities:

1. Ensure member access to appropriate services based on their health needs.
2. Conduct assessments to identify needs and develop care management plans.
3. Implement care plans by facilitating authorizations/referrals within benefits or through extra-contractual arrangements.
4. Coordinate resources to meet identified needs.
5. Monitor and evaluate the effectiveness of care plans, modifying as necessary.
6. Collaborate with Medical Directors and Physician Advisors on treatment plans.
7. Assist in problem solving with providers, claims, or service issues.
8. Contribute to the development of utilization/care management policies and procedures.

Minimum Requirements:

1. BA/BS in a health-related field.
2. At least 3 years of clinical experience or equivalent combination of education and experience.
3. Current, unrestricted RN license in applicable state(s).
4. Multistate licensure is required if providing services in multiple states.

Preferred Skills and Capabilities:

1. Ability to talk and type simultaneously.
2. Certification as a Case Manager.
3. Critical thinking skills in member interactions.
4. Experience with Microsoft Office and ability to learn new systems quickly.
5. Timely response to emails and messages.

Salary range for candidates in California, Colorado, Minnesota, Nevada, Washington State: $68,880 to $118,080. Benefits include comprehensive packages, incentive programs, stock purchase, and 401k contributions. The salary is based on various factors including location, experience, and education.

Additional Information:

Job level: Non-Management Exempt

Work shift: As specified

Job family: MED > Licensed Nurse

Equal Opportunity Employer: Elevance Health considers all applicants without regard to protected categories and provides accommodations upon request.