Nurse Care Mgr I (contract)

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.

Anticipated Start Date: 11/10/2025 Additional Details: Monday through Friday, 8am-5pm PST Nevada Nursing license (Will Reimburse)

Responsible for collaborating with healthcare providers and/or consumer to drive personalized health management and improve health outcomes for optimal consumers. Performs care management activities within the scope of licensure for members with complex and chronic care needs. 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.