RN Full-time
Elevance Health

Telephonic Nurse Case Manager II

$79,464 - $119,196 / year

Anticipated End Date:

2026-04-02

Position Title:

Telephonic Nurse Case Manager II

Job Description:

Telephonic Nurse Case Manager II

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 9:00am to 5:30pm EST and 1 late evening 11:30am to 8:00pm EST.

*****This position will service members in different states; therefore, Multi-State Licensure will be required.

This position requires an on-line pre-employment skills assessment. The assessment is free of charge and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. In order to move forward in the process, you must complete the assessment within 48 hours of receipt and meet the criteria.

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.

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 required.
  • Multi-state licensure is required if this individual is providing services in multiple states.

Preferred Capabilities, Skills and Experiences:

  • Case Management experience.
  • Certification as a Case Manager.
  • Minimum 2 years’ experience in acute care setting. 
  • Managed Care experience.
  • Ability to talk and type at the same time.
  • Demonstrate critical thinking skills when interacting with members.
  • Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.
  • Ability to manage, review and respond to emails/instant messages in a timely fashion.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $79,464 to $119,196.

Location(s): 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). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. 

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Job Level:

Non-Management Exempt

Workshift:

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.

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Utilizes the nursing process to meet the age specific needs of the patient in all aspects of care: biophysical, psychosocial, education, safety/ environment, and discharge planning Utilizes appropriate steps in the decision-making process to include recognition and priority setting related to patient care and unit-based issues. Addresses issues with appropriate actions Administers blood and blood products according to policy Collaborates and communicates with the interdisciplinary health care team Integrates patient rights and nursing ethics into work practice Adheres to infection control standards to reduce the risk of nosocomial infections to patient and staff. Adheres to the tenets of the Joint Commission National Patient Safety Goals Delegates activities to ancillary staff as it relates to the State Nurse Practice Act Adheres to the ANA Code of Nursing Ethics & Scope and Standards of Nursing Practice Supports, promotes, and practices within the WPH Professional Nursing Practice Model Sustains and advances the Magnet model Participates in the Performance Improvement initiatives Completes competency requirements Attends mandatory in-services Attends staff meetings as required/requested Utilizes cost containment practices Assumes Charge Nurse responsibility Performs other related duties as assigned Education & Experience Requirements Graduate from an accredited school of nursing with current New York RN license/registration. BSN Required. Knowledge of current nursing, medical and health trends and practices in rendering of patient care. One year of acute care nursing experience preferred for areas other than medical surgical or step-down BLS certification (through American Heart Association) is required. ACLS certification (through American Heart Association) is required for all RNs, except for NICU and OR RNs. All newly hired, inexperienced nurses must receive this certification within 12 months. All newly hired, experienced nurses must receive this certification within 6 months. PALS certification (through American Heart Association) is required for all RNs working in the PACU, 5I Pediatrics, Emergency Department, Armonk Urgent Care, Ambulatory Surgery and 226 Ambulatory Surgery Center. All newly hired, inexperienced nurses must receive this certification within 12 months. All newly hired, experienced nurses must receive this certification within 6 months. NRP certification is required for all RNs working in the Mother-Baby unit, Labor & Delivery, and NICU. All newly hired nurses to the NICU, L&D, and Mother-Baby must receive this certification within 6 months. Effective 10/31/25 all RNs working on 5I are required to have NRP. Experienced RNs will have 6 months to obtain and new graduates will have 12 months. All registered nurses and advanced practice nurses providing direct oncology care must demonstrate one of the following: Current cancer-specific certification in the nurse’s specialty by an accredited certification program. Oncology nursing certifications that qualify include, but are not limited to: AOCNP®, AOCNS®, AOCN®, BMTCN®, CPHON®, CPON®, CBCN® OCN® or Ongoing education by earning 36 cancer-related continuing education nursing contact hours every 3 years (maintained by department manager) Registered Nurses in the Emergency Department must complete de-escalation training within 1 year of hire to transfer to the Emergency Department. Successful completion of Department and Unit Orientation Program. Core Competencies Teamwork & Adaptability Acts as a Professional Role Model Assessment Skills Excellent Communication Skills (both verbal and written) Attention to Detail Planning & Organizing Sound Problem-Solving, Judgment and Decision-Making Skills Stress Tolerance Physical/Mental Demands/Requirements & Work Environment May be exposed to chemicals necessary to perform required tasks. Any hazardous chemicals the employee may be exposed to are listed in the hospital’s SDS (Safety Data Sheet) database and accessed through the hospital’s Intranet site (Employee Tools/SDS Access). A copy of the SDS database can also be found at the hospital switchboard, saved on a disc. Position requires ability to move about freely at least 85 per cent of the time. Must be able to remain stationary for extended/prolonged periods Frequently moves/transports objects up to fifty (50) pounds and must be able to move patients of all weights with a minimum of one (1) assist or assistive device/equipment Must be able to work in environment with continuous interruptions Must be able to assess and respond to rapidly changing situational needs of patients, department and hospital Must be able to adapt in a high stress and fast-paced environment with multiple interruptions Must be able to detect sounds and respond to emergency sounds/signals at all times Must be able to constantly operate computer, equipment and other devices Position requires ability to concentrate on fine detail with interruptions and attend to tasks for more than sixty (60) minutes at a time. Individual must be able to understand and relate to theories behind several related concepts and remember multiple tasks given during the course of a day. Primary Population Served Check Appropriate Box(s) Below Neonatal (birth – 28 days) Patients with exceptional communication needs Infant (29 days – less than 1 year) Patients with developmental delays Pediatric (1 – 12 years) Patients at end of life Adolescent (13 – 17 years) Patients under isolation precautions Adult (18 – 64 years) Patients with cultural needs Geriatric (> 65 years) ☒All populations Bariatric Patients with weight related comorbidities Non-patient care population The responsibilities and tasks outlined in this job description are not exhaustive and may change as determined by the needs of White Plains Hospital. Salary Range: $117,695-$152,756 (Based on FT hours)