Virtual Nurse Case Manager II (RN)

Elevance Health; Nevada; Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Benefits package

401(k) plan

Stock purchase program

Job summary

Elevance Health in the United States seeks a Nurse Case Manager II (RN) to coordinate care for members with complex and chronic needs. This remote role offers flexibility with in‑person training sessions and periodic office visits as needed.

Candidates must hold a BA/BS in a health‑related field, an active RN license, and multi‑state licensure at hire. California licensure is highly preferred and telephonic/virtual care experience is valued.

Qualifications

• Requires BA/BS in a health-related field and at least 5 years of clinical experience.
• Active RN license in applicable state(s) is required; multi-state licensure on hire.
• California RN license is highly preferred.
• Minimum 2 years of direct Case Management experience.
• Telephonic and/or virtual nursing experience; managed care exposure.
• 2 years’ experience in acute care setting.
• Proficiency with computer systems and software.

Responsibilities

• Conducts assessments to identify needs and creates a care management plan.
• Facilitates authorizations/referrals within benefits structure or through extra-contractual arrangements.
• Monitors and evaluates effectiveness of the care management plan.
• Interfaces with Medical Directors and other health professionals on care plans.
• Assists in problem solving with providers, claims or service issues.
• Contributes to development of utilization/care management policies and procedures.

Skills

Telephonic nursing

Virtual care

Managed care

Case management

MS Office

Education

BA/BS in health-related field

Tools

Microsoft Office

Job description

Elevance Health in the United States seeks a Nurse Case Manager II (RN) to coordinate care for members with complex and chronic needs. This remote role offers flexibility with in‑person training sessions and periodic office visits as needed.

Candidates must hold a BA/BS in a health‑related field, an active RN license, and multi‑state licensure at hire. California licensure is highly preferred and telephonic/virtual care experience is valued.