Telephonic Nurse Case Manager ll

Elevance Health (Anthem); Atlanta (GA); 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 is seeking a Telephonic Nurse Case Manager II to manage complex and chronic patient care plans telephonically across multiple states. The role requires an RN license and multi-state licensure, with in-person training sessions and remote work options.

Hours are standard business times with one late evening per week. Salary ranges from $75,680 to $119,196, with comprehensive benefits and growth opportunities, serving members in multiple states.

Qualifications

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

Responsibilities

• Ensure member access to services appropriate to health needs.
• Conduct assessments to identify needs and develop a care management plan.
• Coordinate authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate effectiveness of the care management plan.
• Interface with Medical Directors and Physician Advisors on care plans.
• Negotiate rates of reimbursement as applicable.
• Assist in problem solving with providers, claims or service issues.
• Help develop utilization/care management policies and procedures.

Skills

RN license

Multi-state licensure

Case management experience

Education

BA/BS in health-related field

Tools

Microsoft Office

Job description

Position Title

Telephonic Nurse Case Manager II

Anticipated End Date: 2026-10-22

Job Description

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 9:00am to 5:30pm EST and 1 late evening 11:30am to 8:00pm EST.

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

This position requires an online pre-employment skills assessment. The assessment is free of charge and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. In order to move forward in the process, you must complete the assessment within 48 hours of receipt and meet the criteria.

The Telephonic Nurse Case Manager II is responsible for 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 designed to optimize member health care across the care continuum. Performs duties telephonically.

How you will make an impact

• 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.
• Managed Care experience.
• Ability to talk and type at the same time.
• Demonstrate critical thinking skills when interacting with members.
• 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.

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

In addition to your salary, Elevance Health offers benefits such as:

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

The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* 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 Comp