Virtual Nurse Case Manager II: Flexible Care Leader

The Elevance Health Companies, Inc.; Indianapolis (IN); Remote; USD 76,000 - 125,000; Full time

Job summary

Elevance Health is seeking a Nurse Case Manager II to manage complex and chronic patient care virtually, with periodic in-person training. The role emphasizes autonomy, care coordination, and adherence to policy while enabling flexible work arrangements within commuting distance constraints.

Responsibilities include assessments, developing and monitoring care plans, coordinating resources, and collaborating with Medical Directors.

Qualifications

• BA/BS in a health-related field plus 5 years of clinical experience or equivalent.
• Current, unrestricted RN license in applicable state(s).
• Multistate licensure required for multi-state service areas.

Responsibilities

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

Skills

RN license

Multistate licensure

Case manager certification

Education

BA/BS health-related field

5 years clinical experience

Job description

Elevance Health is seeking a Nurse Case Manager II to manage complex and chronic patient care virtually, with periodic in-person training. The role emphasizes autonomy, care coordination, and adherence to policy while enabling flexible work arrangements within commuting distance constraints.

Responsibilities include assessments, developing and monitoring care plans, coordinating resources, and collaborating with Medical Directors.