Remote Care Management Coordinator

001 BlueCross and BlueShield of South Carolina; South Carolina; Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Subsidized health plans

401k retirement plan with companymatch

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking a full-time remote Care Manager to coordinate care for high-risk members. You will assess needs, plan actions, monitor progress and advocate for optimal, cost-effective services.

Strong clinical knowledge and excellent communication skills are essential to collaborate with providers, families, and the member. RN licensure and experience in case management are preferred assets.

Qualifications

• Associate degree or nursing-related education with relevant clinical experience.
• RN licensure or equivalent as required by state; compact license acceptable where applicable.
• Experience in case management, utilization review, or clinical coordination preferred.

Responsibilities

• Provide active care management, assess needs, develop action plans with members, monitor services.
• Document clinical information to support medical necessity and benefits.
• Offer telephonic support and patient education to improve engagement and outcomes.
• Coordinate with providers, families, and care teams to ensure continuity of care.
• Promote enrollment in care management and disease management programs.

Skills

Word processing

Analytical thinking

Decision making

Communication skills

Independent work

Education

Associate's degree or equivalent

Bachelor's degree in Nursing (preferred)

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a full-time remote Care Manager to coordinate care for high-risk members. You will assess needs, plan actions, monitor progress and advocate for optimal, cost-effective services.

Strong clinical knowledge and excellent communication skills are essential to collaborate with providers, families, and the member. RN licensure and experience in case management are preferred assets.