Nurse Case Manager I

Anticipated End Date: 2026-11-20 Position Title: Nurse Case Manager 1 100% Virtual, Carebridge Job Description: Nurse Case Manager I 100% Virtual, CareBridge CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services. Location: - Virtual: 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 an accommodation is granted as required by law. Work Hours: - Monday – Friday 11am - 8pm CST Role Overview: The Nurse Case Manager I 100% virtual, CareBridge 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 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. Minimum Requirements: - 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: - Certification as a Case Manager is preferred. - Prior case management experience is strongly preferred. - Home health experience is strongly preferred. Job Level: Non-Management Exempt Workshift: Job Family: MED > Licensed Nurse Other Information: Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elev