Elevance Health
Nurse Care Manager I
Shift:
Monday – Friday; 2:30 pm ET – 11:30 pm EST
Location:
Virtual; alternate locations may be considered if candidates reside within a commuting distance from an office
Virtual Work:
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.
Hybrid/Virtual Policy:
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.
How You Will Make An Impact
Ensures medically appropriate, high‑quality, cost‑effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out‑of‑network services, and appropriateness of treatment setting and level of care.
Partners with physician clinical reviewers and/or medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance.
Collaborates with providers to assess consumer needs for early identification of and proactive planning for discharge.
Conducts clinical assessment to develop goals that address individual needs in order to develop and implement a care plan.
Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
Minimum Requirements
Requires a high school diploma or equivalent and a minimum of 3 years of acute‑care clinical experience; or any combination of education and experience that would provide an equivalent background.
Current, active, unrestricted RN license in the applicable state(s) required.
Multi‑state licensure is required if providing services in multiple states.
Preferred Skills, Capabilities, and Experiences
Home health/discharge planning experience preferred.
AS or BS in nursing preferred.
Certification as a Case Manager preferred.
For URAC accredited areas:
Current and active RN license required in applicable state(s) that allows for an independent assessment to be conducted within their scope of practice. Requires 3 years full‑time equivalent of direct clinical care experience to the consumer; 5 years preferred. Multi‑state licensure is required if providing services in multiple states. Certification as a Case Manager or a BS in a health or human services related field also preferred.
Elevance Health is an Equal Employment Opportunity employer. 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.
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Monday – Friday; 2:30 pm ET – 11:30 pm EST
Location:
Virtual; alternate locations may be considered if candidates reside within a commuting distance from an office
Virtual Work:
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.
Hybrid/Virtual Policy:
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.
How You Will Make An Impact
Ensures medically appropriate, high‑quality, cost‑effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out‑of‑network services, and appropriateness of treatment setting and level of care.
Partners with physician clinical reviewers and/or medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance.
Collaborates with providers to assess consumer needs for early identification of and proactive planning for discharge.
Conducts clinical assessment to develop goals that address individual needs in order to develop and implement a care plan.
Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
Minimum Requirements
Requires a high school diploma or equivalent and a minimum of 3 years of acute‑care clinical experience; or any combination of education and experience that would provide an equivalent background.
Current, active, unrestricted RN license in the applicable state(s) required.
Multi‑state licensure is required if providing services in multiple states.
Preferred Skills, Capabilities, and Experiences
Home health/discharge planning experience preferred.
AS or BS in nursing preferred.
Certification as a Case Manager preferred.
For URAC accredited areas:
Current and active RN license required in applicable state(s) that allows for an independent assessment to be conducted within their scope of practice. Requires 3 years full‑time equivalent of direct clinical care experience to the consumer; 5 years preferred. Multi‑state licensure is required if providing services in multiple states. Certification as a Case Manager or a BS in a health or human services related field also preferred.
Elevance Health is an Equal Employment Opportunity employer. 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.
#J-18808-Ljbffr