Nurse Case Manager II job opportunity at Elevance Health.

Home Jobs In United States Of America Tag: Job Nurse Case Manager II position at Elevance Health


DatePosted Yesterday bot
Elevance Health Nurse Case Manager II
Experience: 5-years
Pattern: full-time
Country:
apply Apply Now
Salary:
Status:

Job

Copy Link Report
degreeAssociate
loacation MO-ST. LOUIS, 100 S 4TH ST, United States Of America
loacation MO-ST. LOUIS, ..........United States Of America

Anticipated End Date: 2026-03-11 Position Title: Nurse Case Manager II Job Description: Telephonic Nurse Case Manager II Sign on Bonus: $3000. 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 8 - 5 pm CST. *****This position will service members in different states; therefore, Multi-State Licensure will be required. 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 or on-site such as at hospitals for discharge planning. 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(s) required. Multi-state licensure is required if this individual is providing services in multiple states. Preferred Capabilities, Skills and Experiences: Case Management experience is preferred. Minimum 2 years’ experience in acute care setting is preferred.  Managed Care experience is preferred. Ability to talk and type at the same time is preferred. Demonstrate critical thinking skills when interacting with members is preferred. Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly is preferred. Ability to manage, review and respond to emails/instant messages in a timely fashion is preferred. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and 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 and financial education resources, to name a few. 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. The health of our associates and communities is a top priority for Elevance Health. We require 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 may contact elevancehealthjobssupport@elevancehealth.com for assistance. 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 .

Other Ai Matches

Outreach Care Specialist - Pasco/ Pinellas County Applicants are expected to have a solid experience in handling Job related tasks
Market Intelligence Manager Applicants are expected to have a solid experience in handling Job related tasks
Provider Network Manager Applicants are expected to have a solid experience in handling Job related tasks
National Accounts Medical Director Applicants are expected to have a solid experience in handling Job related tasks
Marketing Manager (Account Based Marketing) Applicants are expected to have a solid experience in handling Job related tasks
Security Risk Intel Analyst Applicants are expected to have a solid experience in handling Job related tasks
Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)  Applicants are expected to have a solid experience in handling MS-DRG, AP-DRG and APR-DRG) related tasks
Data Analytics Intern- Summer 2026 Applicants are expected to have a solid experience in handling Job related tasks
Process Expert II Applicants are expected to have a solid experience in handling Job related tasks
Documentation Analyst Senior Applicants are expected to have a solid experience in handling Job related tasks
Pharmacy Fulfillment Technician II – BioPlus Specialty Pharmacy Applicants are expected to have a solid experience in handling Job related tasks
CFSP Managed Care Coordinator - Robeson County Applicants are expected to have a solid experience in handling Job related tasks
Clinical Care Advisor - Prevention and Preservation (Region1/2 ) Applicants are expected to have a solid experience in handling Job related tasks
Group Underwriter Senior Applicants are expected to have a solid experience in handling Job related tasks
Field APP Applicants are expected to have a solid experience in handling Job related tasks
Business Change Director Applicants are expected to have a solid experience in handling Job related tasks
Pharmacy Technician II Applicants are expected to have a solid experience in handling Job related tasks
Senior Account Executive - Paragon Healthcare (Clear Lake, TX) Applicants are expected to have a solid experience in handling TX) related tasks
Nurse Case Manager II (US) Applicants are expected to have a solid experience in handling Job related tasks
Appeals Medical Director – Oncology Applicants are expected to have a solid experience in handling Job related tasks
Prior Authorization Representative II Applicants are expected to have a solid experience in handling Job related tasks
Nurse Practitioner 100% Virtual, CareBridge Applicants are expected to have a solid experience in handling CareBridge related tasks
Trade Director CarelonRx Applicants are expected to have a solid experience in handling Job related tasks