Anticipated End Date: 2026-03-30 Position Title: Nurse Case Mgr I Job Description: Nurse Case Manager I Work Schedule: M-F 8am-430pm with 2-3 late evenings a month 1130am-8pm 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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 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. 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 and Capabilities: - Certification as a Case Manager and a 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 $70,560-$105,840 Locations: 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. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: - Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. - Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. - Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results. The Opportunity: CAREER OPPORTUNITY OFFERING: - Bonus Incentives - Paid Certifications - Tuition Reimbursement - Comprehensive Benefits - Career Advancement - This position pays between $56,800.00 – $108,900.00 based on experience This individual will be responsible for reviewing denials and performing root cause analysis while partnering with the Denial Prevention Nurse Manager to improve process and reduce denials. The RN Clinical Appeals performs all appeals for clinically related claim denials across Ensemble Health Partners, or in a role that primarily assists with analyzing and reviewing records to prevent future denials, provide clinical records to payers, and prepare for provider-to-provider (P2P) reviews. Job duties include, but are not limited to, contacting insurance plans to determine reasons claims were denied, analyzing the claims and determining if appeal is necessary, preparing the appeal materials which may include correcting and resubmitting claims, gathering additional information, including reviews of medical records, acting as a liaison between healthcare providers for any additional medical documentation or clarification, and submitting appeals in a timely manner. In addition, the Specialist will work closely with other departments, such as Case Management, HIM, Physician Advisory, Clinical Denials, Denial Prevention, Accounts Receivable, Bedded Inpatient Authorization and Virtual Utilization review, to ensure denial trends and outcomes are communicated in a timely manner. The Specialist will perform these duties while meeting the mission of Ensemble Health Partners, as well as meeting the regulatory compliance requirements. Essential Job Functions: - Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. - ​Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. - Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results. - ​Contacting insurance plans to determine reasons claims were denied, analyzing the claims and determining if appeal is necessary, preparing the appeal materials which may include correcting and resubmitting claims, gathering additional information, including reviews of medical records, acting as a liaison between healthcare providers for any additional medical documentation or clarification, and submitting appeals in a timely manner. In addition, work closely with the Case Management Department and HIM Department to ensure denial trends and outcomes are communicated in a timely manner. This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation. Employment Qualifications: - Current unrestricted license to practice nursing (LPN, RN) - CRCR or other approved professional certification required with 9 months of date of hire Job Experience: - 1 to 3 Years Desired Education Level: - Associates Degree or Equivalent Experience Preferred Area of Study: - Nursing Other Preferred Knowledge, Skills and Abilities: - 4 year/ Bachelors Degree - Preferred Minimum Education - Specialty/Major: Registered Nurse (RN) or relevant discipline - Minimum Years and Type of Experience: 2 years of denials, utilization review, or case management experience strongly preferred Other Knowledge, Skills and Abilities Required: - Proficient computer skills, including Microsoft Suite - Experience in hospital operations, chart audit/review, and provider relations. - Demonstrated advanced usage of AI and the management of teams using AI to lean in to process and technological improvements, to include the exploration, experimentation, and application of AI. - This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require. Join an award-winning company Five-time winner of “Best in KLAS” 2020-2022, 2024-2025 Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024 22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024 Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024 Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023 Energage Top Workplaces USA 2022-2024 Fortune Media Best Workplaces in Healthcare 2024 Monster Top Workplace for Remote Work 2024 Great Place to Work certified 2023-2024 - Innovation - Work-Life Flexibility - Leadership - Purpose + Values Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include: - Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs. - Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation. - Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement. - Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company. Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories. Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com. This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range. Employment Disclaimers – Ensemble

Anticipated End Date: 2026-04-01 Position Title: Nurse Case Manager II Job Description: Telephonic Nurse Case Manager II 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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. Hours: Monday - Friday 10:30 - 7 pm CST. *****This position will service members in different states; therefore, Multi-State Licensure will be required. The Telephonic Nurse Case Manager II 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 5 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 Capabilities, Skills and Experiences: - Case Management experience is preferred. - Minimum 2 years’ experience in acute care setting is preferred. - Managed Care experience is preferred. - Ability to talk and type at the same time is preferred. - Demonstrate critical thinking skills when interacting with members is preferred. - Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly is preferred. - Ability to manage, review and respond to emails/instant messages in a timely fashion is preferred. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $83,248 to $130,548. Locations: Colorado; Washington State. 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: 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. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

*** MSL is a must a long with RN license*** Job Summary: Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and care coordination for members, as well as monitoring the delivery of healthcare services. Essential Functions: - Complete prospective, concurrent and retrospective review such as acute inpatient admissions, post-acute admissions, elective inpatient admissions, outpatient procedures, homecare services and durable medical equipment - Identify, document, communicate, and coordinate care, engaging collaborative care partners to facilitate transitions to an appropriate level of care - Engage with medical director when additional clinical expertise if needed - Maintain knowledge of state and federal regulations governing CareSource, State Contracts and Provider Agreements, benefits, and accreditation standards - Identify and refer quality issues to Quality Improvement - Identify and refer appropriate members for Care Management - Provide guidance to non-clinical staff - Provide guidance and support to LPN clinical staff as appropriate - Attend medical advisement and State Hearing meetings, as requested - Assist Team Leader with special projects or research, as requested - Perform any other job related duties as requested. Education and Experience: - Associates of Science (A.S) Completion of an accredited registered nursing (RN) degree program required - Three (3) years clinical experience required - Med/surgical, emergency acute clinical care or home health experience preferred - Utilization Management/Utilization Review experience preferred - Medicaid/Medicare/Commercial experience preferred Competencies, Knowledge and Skills: - Proficient data entry skills and ability to navigate clinical platforms successfully - Working knowledge of Microsoft Outlook, Word, and Excel - Effective oral and written communication skills - Ability to work independently and within a team environment - Attention to detail - Proper grammar usage and phone etiquette - Time management and prioritization skills - Customer service oriented - Decision making/problem solving skills - Strong organizational skills - Change resiliency Licensure and Certification: - Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice required - MCG Certification or must be obtained within six (6) months of hire required Working Conditions: - General office environment; may be required to sit or stand for extended periods of time - Travel is not typically required Compensation Range: $62,700.00 - $100,400.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Hourly Organization Level Competencies - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-JM1