Telephonic RN Nurse Case Manager II - AmeriBen

The Elevance Health Companies, Inc.; Indianapolis (IN); Remote; USD 85,000 - 110,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid Time Off

401(k) + match

Stock purchase plan

Medical

Dental

Vision

Job summary

Elevance Health is seeking a Telephonic RN Nurse Case Manager II - AmeriBen to coordinate member care and facilitate services across the benefits structure in a fully remote, full-time capacity.

The role requires an active RN license and multi-state licensure where applicable, with in-person training sessions. You will conduct assessments, build care plans, arrange referrals, and collaborate with medical staff to optimize outcomes while adhering to guidelines.

Qualifications

• Requires BA/BS in a health-related field and clinical experience; RN license valid in applicable states.
• Current, unrestricted RN license in applicable state(s) required.
• 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 needs and develops a care management plan.
• Implements care plan by facilitating authorizations/referrals within benefits or through arrangements.
• Coordinates internal and external resources to meet identified needs.
• Monitors and evaluates effectiveness of the care management plan and updates as needed.
• Interfaces with Medical Directors and Physician Advisors on care plans.

Skills

Utilization review

Prior authorization

Clinical case management

Microsoft Office

Email/communication

Education

Bachelor of Science in Nursing (BSN)

Job description

Anticipated End Date: 2026-10-14

Position Title: Telephonic RN Nurse Case Manager II - AmeriBen

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. 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 thru Friday 8 am to 5 pm (local time)

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.
• Assists in problem solving with providers.
• 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(s) required.
• Multi‑state licensure is required if this individual provides services in multiple states.

Preferred Capabilities, Skills and Experiences:

• Previous experience with utilization review and/or prior authorization.
• Clinical case management experience in an inpatient or outpatient setting.
• Ability to talk, type and critically think at the same time.
• Demonstrates 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.
• Excellent collaboration, communication and teamwork skills.

Job Level: Non-Management Exempt

Workshift: 1st Shift (United States of America)

Job Family: MED > Licensed Nurse

Benefits:

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs (unless covered by a collective bargaining agreement)
• Medical
• Dental
• Vision
• Short and long term disability benefits
• 401(k)+match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

Elevance Health requires all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Please visit the Contract Worker Community Page.

Elevance Health is an Equal Opportunity Employer/Disability/Veterans.