Medical Management Nurse (California)
Elevance Health · Burbank
- Pay
- Not listed
- Job type
- Full-time
- Work mode
- Remote
- Category
- Healthcare
- Neighborhood
- Burbank
- Posted
- August 28, 2026 (yesterday)
- Last verified
- August 28, 2026
🏠 This is a remote role from a Burbank-based employer — it's on the board because the employer is local to the Valley, not the desk.
About the Role
Reviews the most complex utilization-management cases, applying nursing judgment and clinical guidelines to determine medical necessity of requested services, and consulting with the Medical Director on unclear or complex cases. California-based role.
What You'll Do
- Analyze members' clinical information and apply clinical guidelines to evaluate medical necessity
- Collaborate with healthcare providers to promote quality outcomes and effective use of resources
- Collaborate with case management nurses on discharge planning
- Serve as a resource to other nurses and support process-improvement initiatives
Requirements
- Associate's degree in nursing (minimum)
- 4+ years of care/case management experience; 2+ years of clinical, utilization review, or managed care experience
- Current, active, unrestricted RN license (multi-state if applicable)
Schedule
Full-time, remote (California-based).
This listing comes from Elevance Health's own careers feed and was last verified against it on August 28, 2026. Stale listings are removed automatically.
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Medical Management Nurse (California)
Elevance Health