Clinical Case Manager

Bluecross-Blueshield-of-Vermon; Berlin (VT); On-site; USD 75,000 - 85,000; Full time

Benefits offered by this job

Dental coverage

Wellness Program

401(k) with employer match

Life Insurance

Disability Insurance

Paid time off and holidays

Tuition Reimbursement

Student Loan Repayment

Dependent Caregiver Benefits

Job summary

Blue Cross and Blue Shield of Vermont is seeking a Clinical Case Manager to join our Integrated Health team. This role targets licensed clinicians with in-state case management experience to support members with complex health needs.

The position offers a base salary of $75,000–$85,000 with additional compensation opportunities and a hybrid work model. Remote work is available for eligible candidates, with in-office Wednesdays in Berlin, VT.

Qualifications

• Graduate of an approved program in professional nursing with VT licensure (compact/multi-state license preferred).
• Licensed Clinical Social Worker (LICSW) in VT or equivalent licensure in allied mental health field.
• 5 years of varied clinical practice; 1–3 years in case management; CCM certification preferred or pursued within 3 years of hire.

Responsibilities

• Perform case management processes—assessment, planning, facilitation, coordination, monitoring, evaluation, advocacy.
• Conduct comprehensive assessments and develop personalized care plans using evidence-based tools.
• Collaborate with members, families, and providers across care settings to meet health goals.
• Support members through health journeys, coordinating with service lines and plan teams.
• Engage with clinical team to ensure the best possible outcomes for members.
• Contribute to department-wide initiatives to improve care quality and manage costs.

Skills

RN licensure VT

LICSW or allied licensure

CCM certification (preferred)

Case management experience

Multidisciplinary collaboration

Education

RN program with VT licensure

BSN desired

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Clinical Case Manager

Regular Full-Time US 1 Attachments

30+ days ago Requisition ID: 1616

Blue Cross and Blue Shield of Vermont is looking for a Clinical Case Manager to join our Integrated Health team. Strong candidates include registered nurses or other licensed clinicians in the State of Vermont with case management experience in a health care setting. Our company culture is built on an unwavering focus on our members and giving them the best service possible. We offer a balanced, flexible workplace, an onsite gym, fitness and wellness programs, a competitive salary and full benefits package including medical and dental insurance, vision, 401k, paid time off and holidays, tuition reimbursement and student loan repayment, dependent caregiver benefits, and resources to support your ongoing personal and professional growth and development.

COMPENSATION:The base salary range for this position is $75,000 - $85,000. Additional compensation opportunities and incentives will be detailed during the interview process. Please note that the range listed above is our good faith estimate of the hiring range for this role. If you are hired at Blue Cross and Blue Shield of Vermont, your final base salary compensation will be determined based on factors such as skills, competencies, education, experience, and internal equity across the current team. We also offer a robust benefits package with significant value (see below).

Remote Work: Blue Cross has transitioned to a hybrid workplace where employees within driving distance of our Berlin, VT office work Wednesdays in the office with flexibility to work remotely the rest of the week. This role can also be filled by a fully remote candidate outside of the 50 mile radius.

Clinical Case Manager Responsibilities:

• Perform the primary functions of case management-assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy-as appropriate in the health plan context to help members with high health complexity overcome biological, psychological, social and/or health system barriers to improvement and to achieve their desired clinical and functional outcomes.
• Conduct comprehensive assessments and develop personalized care plans in accordance with professional case management and accreditation standards, using evidence-based tools and applying relationship-building, motivational interviewing, risk-prioritization, and other related skills.
• Work collaboratively with members, families, and providers throughout the case management process, drawing upon knowledge of clinical, regulatory, and quality standards, health plan products and benefits, and community resources.
• Support members at all stages of their health care journey and across multiple settings and specialty areas, connecting with multiple providers and community-based organizations; guide members in accessing services to support their health and wellness goals in accordance with their benefits, partnering effectively with the Plan's customer service, providers relations, and/or utilization management teams.
• Demonstrate a commitment to integrated, multi-disciplinary practice by proactively tapping into the expertise of the Plan's clinical team of physicians, nurses, mental health clinicians, pharmacists, and colleagues in other departments who can help ensure the best possible experience and outcomes for the member.
• Participate in department and organization-wide initiatives to enhance member health and wellness, improve the quality of care, and generate cost-savings for our customers.

Clinical Case Manager Qualifications:

• Graduate of an approved program in professional nursing: RN, VT licensure and ability to apply for Compact License or active multi-state licensure required, BSN desired;
• OR Licensed Clinical Social Worker (LICSW) in the State of Vermont or comparable degree and licensure in an allied mental health profession.
• 5 years of varied clinical practice experience required, preferably in a health care setting. Experience in the following clinical areas strongly desired: inpatient and post-discharge care, management of chronic conditions, including medical and mental health conditions, and substance use disorders.
• 1-3 years of case management or similar experience desired.
• Active CCM certification preferred or initiated within 2 years of hire. Completion of CCM certification required within 3 years of hire

Clinical Case Manager Benefits:

• Dental coverage (free to employees)
• Wellness Program
• 401(k) with employer match + automatic employer contribution
• Life Insurance
• Disability Insurance
• Combined time off (CTO) - 20 days per year + 9 paid holidays
• Tuition Reimbursement
• Student Loan Repayment
• Dependent Caregiver Benefits

Diversity, Equity, and Inclusion: Blue Cross VT is committed to creating an inclusive environment where employees respect, appreciate, and value individual differences, both among ourselves and in our communities. We welcome applicants from all backgrounds and experiences to join us in our commitment to the health of Vermonters, outstanding member experiences, and responsible cost management for all the people whose lives we touch. Learn more about our DE&I commitment athttp://www.bluecrossvt.org/about/diversity-equity-and-inclusion .