Telephonic Nurse Case Manager I

Elevance Health; West Des Moines (IA); Remote; USD 68,000 - 119,000; Full time

Job summary

A leading healthcare company seeks a Telephonic Nurse Case Manager I to perform care management for members with complex needs. This role offers virtual flexibility while ensuring effective health service delivery. Candidates must have a relevant degree and clinical experience, along with a current RN license. Join a team dedicated to improving lives and communities.

Benefits

Comprehensive benefits packages

Incentive programs

401k

Stock purchase options

Paid holidays

PTO

Wellness programs

Qualifications

• 3 years of clinical experience or equivalent education and experience.
• Current, unrestricted RN license in applicable state(s).

Responsibilities

• Conduct assessments to identify needs and develop specific care management plans.
• Monitor and evaluate the effectiveness of care plans, modifying as necessary.
• Coordinate resources to meet identified needs.

Skills

Critical thinking

Communication

Multi-State licensure

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 note: This position will service members in different states; therefore, Multi-State Licensure will be required.

It requires an online pre-employment skills assessment, which is free and can be completed from any PC with internet access. Candidates meeting the minimum requirements will be contacted via email with instructions. Completion within 48 hours of receipt is necessary to proceed.

The Telephonic Nurse Case Manager I is responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans to optimize member health across the continuum. Duties are performed telephonically.

How you will make an impact:

1. Ensure member access to services appropriate to their health needs.
2. Conduct assessments to identify needs and develop specific 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. Interface with Medical Directors and Physician Advisors on treatment plans.
7. Assist in resolving problems with providers, claims, or services.
8. Contribute to the development of utilization and 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 education and experience.
3. Current, unrestricted RN license in applicable state(s).
4. Multi-State licensure required if providing services in multiple states.

Preferred Capabilities, Skills, and Experiences:

1. Ability to talk and type simultaneously.
2. Certification as a Case Manager.
3. Critical thinking skills when interacting with members.
4. Experience with Microsoft Office and ability to learn new systems quickly.
5. Ability to manage and respond to emails and messages promptly.

Salary range for candidates in California, Colorado, Minnesota, Nevada, Washington State: $68,880 to $118,080.

Additional benefits include comprehensive packages, incentive programs, stock purchase, 401k, and more. The actual salary depends on various factors including experience, location, and skills.

Job Level: Non-Management Exempt

Workshift: As specified

Job Family: MED > Licensed Nurse

Elevance Health only accepts resumes from agencies with a signed agreement. Unsolicited resumes are property of Elevance Health.

Who We Are: Elevance Health is dedicated to improving lives and communities, a Fortune 25 company with a long-standing healthcare industry presence.

How We Work: We foster a culture of growth, aligned with our values and behaviors. Our rewards include merit increases, paid holidays, PTO, benefits, 401(k), stock plans, and wellness programs.

Our hybrid workforce strategy requires associates to work onsite at least once a week unless specified otherwise. Specific onsite requirements will be discussed during hiring.

We prioritize health and safety, requiring COVID-19 and Influenza vaccinations for certain roles, unless an exemption is provided.

Elevance Health is an Equal Employment Opportunity employer. Accommodations for application process are available upon request. Applicants with arrest or conviction records will be considered per applicable laws.