Remote Case Manager, RN – Care Coordination & Outcomes

Excellus BlueCross BlueShield; City of Utica (NY); Hybrid; USD 62,000 - 120,000; Full time

Benefits offered by this job

Remote work possible

Job summary

Excellus BlueCross BlueShield is seeking a skilled Case Manager to conduct program activities in accordance with CMS, NCQA, NYS DOH and other standards. You will identify members, educate and support them, and coordinate care with providers and community resources.

You will collaborate with an interdisciplinary team to develop comprehensive care plans, address health goals, and optimize outcomes while controlling costs.

Qualifications

• Associates degree required; Bachelor’s degree preferred.
• Active NYS RN or Registered Dietitian or Physical Therapist licensure required.
• Minimum of three years clinical experience; Case Management experience preferred.
• Proficiency with Microsoft Office Suite.
• Experience interpreting managed care benefit plans and government program contracts.

Responsibilities

• Manage physical health member clinical management programs.
• Collaborate with providers and care team to develop interdisciplinary care plans.
• Coordinate services and resources to support member health goals.
• Maintain confidentiality and meet regulatory requirements.

Skills

Multitasking

Written & verbal communication

Collaboration

Education

Associates degree required

Bachelor’s degree preferred

NYS RN license or Dietician or PT licensure required

Tools

Microsoft Office

Job description

Excellus BlueCross BlueShield is seeking a skilled Case Manager to conduct program activities in accordance with CMS, NCQA, NYS DOH and other standards. You will identify members, educate and support them, and coordinate care with providers and community resources.

You will collaborate with an interdisciplinary team to develop comprehensive care plans, address health goals, and optimize outcomes while controlling costs.