Telephonic Nurse Case Manager II

Elevance Health (Anthem); Boght Corners (NY); Remote; USD 76,000 - 119,000; Full time

Benefits offered by this job

comprehensive benefits package

incentive and recognition programs

equity stock purchase

401k contribution

Job summary

Elevance Health in the United States is hiring a Telephonic Nurse Case Manager II to coordinate care for members remotely, with in-person training sessions as required. This role supports work-life balance and autonomy while ensuring high-quality case management.

Candidates must have a BA/BS in a health-related field and RN licensure; multi-state licensure is required for cross-state service. The job includes coordinating authorizations, developing care plans, and collaborating with medical

Qualifications

• Requires BA/BS in a health-related field and 5 years of clinical experience.
• Current, unrestricted RN license in applicable state.
• Multi-state licensure required if providing services in multiple states.

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
• Implements care plan by facilitating authorizations/referrals as appropriate 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 Physician Advisors on the development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Skills

Case management

Microsoft Office

Education

BA/BS in health-related field

Tools

Microsoft Office

Job description

Anticipated End Date

2026-10-21

Position Title

Telephonic Nurse Case Manager II

Job Description

Telephonic Nurse Case Manager II

Location

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. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Hours

Monday-Friday 8:30am to 5:00pm in your time zone, with 2-4 late shifts per month (11:30 AM-8:00 PM EST).

Licensure

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

Responsibilities

• Ensures member access to services appropriate to their health needs.
• Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
• Implements care plan by facilitating authorizations/referrals as appropriate 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 Physician Advisors on the development of care management treatment plans.
• Negotiates rates of reimbursement, as applicable.
• Assists in problem solving with providers, claims or service issues.
• Assists with development of utilization/care management policies and procedures.

Minimum Requirements

• Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted RN license in applicable state required.
• Multi-state licensure is required if this individual is providing services in multiple states.

Preferred Capabilities, Skills and Experiences

• Case Management experience.
• Certification as a Case Manager.
• Minimum 2 years' experience in acute care setting.
• Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.
• Ability to manage, review and respond to emails/instant messages in a timely fashion.

Salary

For candidates working in person or virtually in the below locations, the salary range for this specific position is $75,680 to $119,196.

Location(s)

New York, Virginia

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Job Level

Non-Management Exempt

Job Family

MED > Licensed Nurse

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communiti