Nurse Case Manager I

Location

This role enables associates to work virtually full-time, except for 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 accommodation is granted as required by law.

HOURS

Monday - Friday 9:00a - 5:30p ET with 2-4 late evening shifts per month, 11:30a to 8p ET.

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.
• Collaborates with internal and external resources to meet identified needs.
• Maintains and monitors the effectiveness of the care plan and modifies as necessary.
• Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
• Aids in problem-solving with providers, claims, or service issues.
• Functions as a preceptor for new care management staff.
• Works on special projects as assigned by manager.
• Performs other duties as assigned.

Minimum Requirements

• Requires BA/BS in a health-related field and minimum of 3 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 is providing services in multiple states.

Preferred Skills, Capabilities And Experiences

• Previous case management experience is preferred.
• Home health experience, utilization management, and/or hospital discharge planning experience is a plus.

Benefits

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $70,560 to $105,840. Location: New York. In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

About the Role

The Nurse Case Manager I is responsible for performing 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 or on-site as needed.