RN Full-time

Anticipated End Date:

2026-01-31

Position Title:

Family Care-Registered Nurse

Job Description:

LTSS Service Coordinator - RN Clinician (RN Case Manager)

Hiring near Southwestern Wisconsin in counties: Pepin, Buffalo, Trempealeau, Jackson, Clark, La Crosse, Monroe, Juneau, Vernon, Sauk, Richland, Crawford, Grant, Iowa, Lafayette, Green.

Location: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. 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.

Anthem is very excited to be a managed care organization in western/southwestern Wisconsin and Milwaukee County to offer the Family Care Program. Family Care is a Wisconsin long-term care program for older adults and adults with disabilities. Our goal is that each member will experience the life they choose with supports to maximize independent living, employment, and contributing to their communities.  

The LTSS Service Coordinator-RN Clinician is responsible for overall management of member's case within the scope of licensure, develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of prioritizing person-centered thinking and optimizing member health care across the care continuum.

How you will make an impact:

  • Responsible for performing telephonic and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports. Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team. 
  • Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. 
  • Obtains a thorough and accurate member history to develop an individual care plan. 
  • Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs. 
  • The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services. 
  • May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible. 
  • Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management of person-centered care plans. May also assist in problem solving with providers, claims or service issues. 

Minimum Requirements:

  • Requires a high school diploma or GED equivalent and minimum of 3 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background. 
  • Current, active valid and unrestricted RN license in applicable state(s) required.

Preferred Skills, Capabilities and Experiences: 

  • BA/BS in Health/Nursing preferred.
  • Strong preference for case management experience with older adults or individuals with disabilities.
  • Long Term Care background preferred
  • Commitment to member-centered care and cultural responsiveness.
  • Family Care/Partnership experience preferred.
  • Comfortable using technology preferred.
  • Strong interpersonal and communication skills
  • Ability to work collaboratively in team environment
  • Problem solving and crisis management abilities
  • Travels to worksite and other locations including members home/community for in-person visits.

Job Level:

Non-Management Non-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.

Share this job

Share to FB Share to LinkedIn Share to Twitter

Related Jobs

RN Full-time
Molina Healthcare

IRIS Self-Directed Personal Care (RN) (La Crosse County, WI & Vernon County, WI)

Home Health Care, Hospice Care, Palliative Care, Long Term Care, Rehab No weekends, No afterhours support, No holidays Job Description Job Summary Are you seeking a unique nursing position that gives you a great work/life balance and lets you support people to live the lives that they choose? Then you’ll want to keep reading about this rewarding work opportunity! We are currently looking for a Registered Nurse licensed in Wisconsin to become our next IRIS Self-Directed Personal Care (SDPC) RN. This is a remote position, where you will partner with people in your community who are enrolled in the Wisconsin IRIS program – a Medicaid long-term care option for older adults and people with disabilities. People in the IRIS program who need personal care services have the choice to enroll in the IRIS Self-Directed Personal Care (IRIS SPDC) option. You can learn more about IRIS SDPC on the Wisconsin Department of Health Services website here , and learn about the IRIS program here . While this role is home-based, you will have regularly scheduled visits with people in their homes and communities. As an IRIS SDPC RN, you’ll provide oversight and guidance to the people enrolled in the IRIS SDPC option. You’ll also build relationships with the people you partner with and ensure that they’re getting the most out of the IRIS Self-Directed Personal Care option through assessment, oversight, training and education. IRIS SDPC RNs are responsible for administering the Wisconsin Personal Care Screening Tool; creating person-centered plans of care; providing personal care oversight to a group of people in IRIS, providing education and training for IRIS participants and care providers, and conducting the required documentation and follow-up. As an IRIS SDPC RN, you’ll play an important role in helping people of various backgrounds and abilities live their lives the way they choose. Knowledge/Skills/Abilities Provides personal care assessments and oversight to the My Cares Groups by administering the Wisconsin Personal Care Screening Tool and addendums as required Documents assessment as required by individual tool and Department of Health Services policies and by completing oversight visits and calls as required Oversees a My Cares Groups of participants, develops individual plans of care, ensures physician orders for care are obtained and reviews and revises plan of care as needed Submits for Prior Authorization for personal care services Complies with all Department of Health Services policies and SDPC Guidelines, procedures, and practices along with documentation and program regulations Provides personal care training to participants or care providers as requested and provides educational materials as needed Completes collateral contacts with IRIS Consultants and Long-Term Care Functional Screeners and physicians to ensure care needs are met Completes other duties as assigned Overtime work may be required May be required to drive 50% of the time during a given day of member home visits Exposure to members homes which may include navigating stairs, exposure to different environments, and pets Required Qualifications • At least 2 years nursing experience, and at least 1 year of experience serving the target groups of the IRIS program (adults with physical/intellectual disabilities or older adults), or equivalent combination of relevant education and experience. • Active and unrestricted Registered Nurse (RN) license in the state of Wisconsin. • Associate's degree in nursing. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements unless otherwise required by law. • Database operation/maintenance skills and data entry experience. • Teaching and mentoring skills. • Analytical and problem-solving skills. • Strong organizational and time-management skills, and ability to manage tasks independently. • Flexibility in the work environment, and willingness and ability to adapt to changing organizational needs. • Strong written and verbal communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Experience providing care through the Wisconsin Medical Assistance Personal Care program (MPAC). • Home care/home health experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V #PJNurse #HTF Pay Range: $26.41 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
RN Urgent Care Part-time
Gundersen Health System

RN, Registered Nurse | Onalaska Urgent Care

Love + medicine is who we are, it's what we do, it's why people want to work here. If you’re looking for a job to love, apply today. Scheduled Weekly Hours: 24 Emplify Health by Gundersen is seeking a part-time Registered Nurse to join our highly committed and driven Onalaska Urgent Care team as we provide excellent quality care to over 36,000 patients of all ages annually. What You'll Do: As a Registered Nurse, you will play a direct role in providing LOVE + MEDICINE for a broad range of patient acuities. You will be expected to perform with a high degree of clinical and professional aptitude while helping deliver patient care as part of a multidisciplinary team includes MDs, DOs, PAs, NPs, EMTs, Health Unit Coordinators, and Social Workers. Nurses in our Onalaska Urgent Care provide care to over 100-150 patients daily with a wide variety of physical and emotional needs. The department consists of 20 total patient treatment spaces including 13 exam rooms, 4 procedure rooms, 2 consult/discharge rooms, and one Provider-in-Triage room, offering health services to patients ranging from pediatric to geriatric. Urgent Care does see Emergency-level patients, based on the Emergency Severity Index (ESI) if a patient requires further emergent care, our team will collaborate to stabilize and safely transfer the patient to Emergency Services at our main hospital campus in La Crosse, WI. What's Available: Part time - 48 hours biweekly (0.6 FTE). Will orientate/train as close to full-time as possible 12hr shifts with every third weekend & holiday. Typical shifts are 6:30a-6:30p, 8a-8p, 9a-9p, 10:15a-10:15p Starting pay of $38.01 per hour and up, based on your years of experience, as well as generous shift/weekend/holiday differentials What You'll Need: A minimum of an Associate's degree in Nursing An active Wisconsin or multi-state RN license upon start Current Infant-Adult Basic Life Support for Health Care Providers Ability to provide compassionate care to patients of all ages, including toddlers and adults Excellent communication and interpersonal skills to effectively interact with patients, families, and healthcare team members Ability to work independently as well as collaboratively within a team environment Three years recent acute RN experience is highly desired What You'll Get: Unlimited potential at one of the leading health systems in the midwestern United States A highly adaptable and mission-driven organization with a work environment that supports you personally and professionally and a work culture where you are valued and appreciated Departmental leadership that supports you as you do your best work including a Clinical Nurse Leader (CNL), Clinical Manager, Professional Development Nurse, and Quality Improvement Specialist Nurse A team-oriented department focused on teaching, which is guaranteed to expand critical thinking skills and nursing skillset Have your voice heard through our Nursing Shared Governance Councils Support for your career growth through Professional Development Opportunities, our Tuition Investment Program, and Career Development Center Competitive Compensation: Enjoy an attractive hourly rate, based on your years of experience, as well as generous shift differentials, ensuring your skills and dedication are valued and rewarded A comprehensive and generous benefits package (Medical, Dental, Life Ins, HSA/FSA) ensuring your comfort and well-being as a valuable team member Substantial retirement contribution including 401k match & annual discretionary base contribution Paid Time Off (PTO) combines vacation, sick, and personal days into one balance to allow you the flexibility to use your time off as you need Other benefits include a Wellness program with incentives, employer-paid life insurance and AD&D, optional short-term and long-term disability coverage, an employee assistance program, identity theft protection, pet insurance, Inspire & Celebrate colleague recognition and rewards program, a discount program, and more! Relocation assistance available Urgent Care is a high-energy, patient-centered environment that serves every patient population from infancy to the elderly. You can be a nurse anywhere. But not everywhere practices LOVE + MEDICINE. Join us as we provide excellent, compassionate care to our community all while doing the work you love in the beautiful coulee region ! About Us: Emplify health by Gundersen is the leading provider of primary and specialized care in western Wisconsin, southeast Minnesota, and northeast Iowa, serving more than 500,000 residents throughout 19 counties annually. Our physician-led, not-for-profit healthcare system includes a 325-bed teaching hospital and Level II Trauma Center; community clinics; affiliate hospitals, clinics, and nursing homes; behavioral health services; vision centers; pharmacies; and air and ground ambulance services. Our mission is simple yet profound: Together, we inspire your best life by relentlessly caring, learning, and innovating. We deliver Love + Medicine every day to change lives in our communities and enrich the lives of our employees. I f you need assistance with any portion of the application or have questions about the position, please contact HR-Recruitment@gundersenhealth.org or call 608-775-0267. We inspire your best life by relentlessly caring, learning and innovating. This is our purpose. Together with our values — belonging, respect, excellence, accountability, teamwork and humility — our pillars set our foundation and our future. Equal Opportunity Employer
RN Full-time
Elevance Health

Nurse Case Mgr I (US)

$68,880 - $108,240 / YEAR
Anticipated End Date: 2026-01-15 Position Title: Nurse Case Mgr I (US) Job Description: Nurse Case Manager I Hours: 9am-5:30pm EST with 2 -3 evening shifts a month 11:30am-8pm EST 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. 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. The Nurse Case Manager I 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 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. BS in a health or human services related field preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $68,880- $108,240 Locations: Illinois, 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 considered to be 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.
RN Infusion Full-time
Elevance Health

RN Specialty Home Infusion Nurse

Anticipated End Date: 2026-01-25 Position Title: RN Specialty Home Infusion Nurse Job Description: A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered lasting pharmacy care. LOCATION : This is a field role in the Dallas area providing home infusion services to our members. HOURS : Monday through Friday, 8:00 am - 5:00 PM, CST. TRAVEL : Travel within your assigned area is required. When you are not in the field, you will work virtually from your home. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. 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. The RN Specialty Home Infusion Nurse is responsible for coordinating and performing infusion nursing care for patients in the home setting. Primary duties may include, but are not limited to : Administers skilled nursing care; participates in educating patients and caregivers home medical management; provides leadership by working cooperatively to establish priorities and goals of patient care. Completes patient assessments, patient/caregiver teaching, development and revision of the plan of care, implementation of physician orders, monitoring patient response, response to emergency patient needs and psychosocial support. Follows company policies and procedures as well as INS standards of practice, OSHA guidelines, State Nurse Practice Act and state board laws/guidelines. Provides pre-discharge patient assessments in the hospital or clinic setting, when appropriate. Completes all required patient care documentation and reports accurately. Submits all required patient care documentation and reports in a timely manner. Communicates to supervisor, physicians and other health care providers, as appropriate, any changes in the patient’s condition. May have on call responsibility as assigned to provide 24 hour availability and provides these services in accordance with established protocols. Utilizes universal precaution when working in potentially hazardous situations (e.g. handling of blood and body fluids). May participate in the orientation of other nurses as requested. Provided educational programs or visits to referrals sources, as requested. Required Qualifications Requires AS in nursing and minimum of 2 years of clinical experience or home health experience; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license from the state of Texas required. Satisfactory completion of a Tuberculosis test is a requirement for this position and Hepatitis B vaccine or signed waiver. Preferred Qualifications Infusion nursing experience in a clinical or home setting is very strongly preferred. BSN is preferred. Job Level: Non-Management Non-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.
RN Full-time
Elevance Health

Nurse Case Manager I

$36.28 - $56.77 / HOUR
Anticipated End Date: 2026-01-17 Position Title: Nurse Case Manager I Job Description: 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. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting locations will not be considered for employment, unless an accommodation is granted as required by law. 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 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 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 (CA) required. Preferred Skills, Capabilities and Experiences : Certification as a Case Manager is preferred. Pediatrics experience highly preferred. For candidates working in person or virtually in the below location, the hourly* range for this specific position is $36.28 to $56.77 Location: California 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 Non-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.