Pediatric Nurse Case Manager
Listed on 2026-07-21
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Nursing
Pediatric Nurse Case Manager I
End Date:
Location:
Candidates should reside within a reasonable distance of the Tampa, FL office. Residents of Pinellas County (Largo, St. Petersburg, Clearwater) are strongly encouraged to apply.
Field:
This field-based role primarily operates in the field, traveling to client sites or designated locations as required, with occasional office attendance for meetings or training.
Shift: Monday – Friday, 8:00AM to 5:00PM EST.
Responsibilities- Perform care management within the scope of licensure for members with complex and chronic care needs, including assessment, development, implementation, coordination, monitoring, and evaluation of care plans.
- Conduct assessments to identify individual needs and develop specific care management plans to address identified objectives and goals.
- Implement care plans by facilitating authorizations and referrals within the benefits structure or through extra‑contractual arrangements.
- Coordinate internal and external resources to meet identified needs.
- Monitor and evaluate the effectiveness of care management plans and modify as necessary.
- Interface with Medical Directors and Physician Advisors on the development of treatment plans.
- Negotiate rates of reimbursement, as applicable.
- Assist in problem‑solving with providers, claims, or service issues.
- BA/BS in a health‑related field and a minimum of 3 years of clinical experience; or an equivalent combination of education and experience.
- Current, unrestricted RN license in the state of Florida.
- Proficiency in two or more languages, with a preference for bilingual candidates.
- Certification as a Case Manager.
- At least 2 years of experience with the pediatric population.
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.
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