Pediatric Nurse Case Manager

Position Title:

Pediatric Nurse Case Manager I

Anticipated End Date:
July 27, 2026

Location:

Tampa, FL (within reasonable commuting distance of our Tampa office; candidates in Pinellas County – Largo, St. Petersburg, Clearwater – are strongly encouraged).

Field‑based role primarily operating in the field, traveling to client sites or designated locations as required, with occasional office attendance for meetings or training. Monday – Friday, 8AM to 5PM EST.

• Perform care management within licensure scope for members with complex and chronic pediatric needs.
• Assess, develop, implement, coordinate, monitor, and evaluate care plans to optimize member health care across the continuum.
• Conduct assessments to identify individual needs and specific care‑management plans for objectives and goals.
• Implement care plans by facilitating authorizations/referrals as appropriate within benefits structure or via extra‑contractual arrangements.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate effectiveness of care plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on development of treatment plans.
• Negotiate reimbursement rates, where applicable.
• Assist in problem‑solving with providers, claims or service issues.

• BA/BS in a health‑related field and minimum 3 years of clinical experience; or equivalent combination of education and experience.
• Current, unrestricted RN license in Florida.
• Preferred:
  Bilingual;
  Case‑Manager certification; 2+ years pediatric experience.

Elevance Health is an Equal Employment Opportunity employer and will consider all qualified applicants without regard to age, citizenship, or other protected classes.