Remote Complex Case Manager, RN – Care Coordination

Visa Hunt; United States; On-site; USD 60,000 - 90,000; Full time

Job summary

BCBST BlueCross BlueShield of Tennessee, Inc. is hiring a Case Manager to manage complex members with significant medical and psychosocial needs, delivering care digitally and telephonically. The role emphasizes clinical judgment, utilization management, and coordination across providers and benefits programs.

The ideal candidate has an active RN license (TN or compact), 3 years of clinical experience and strong digital literacy. This remote position requires Monday–Friday 8:00 a.m.–5:00 p.m.

Qualifications

• RN license in TN or home state if compact.
• 3 years clinical experience required.
• 5 years healthcare industry experience.
• 2 years IDD experience for Select Community is required.

Responsibilities

• Support utilization management for complex/non-routine cases.
• Liaise between members, providers and internal/external customers in care delivery and benefits coordination.
• Oversee highly complex cases to ensure interventions and benefits are used efficiently.
• Perform core case management activities: assessment, planning, implementation, coordinating, monitoring, outcomes and evaluation.
• Digital channels communication and technical support.

Skills

Communication

RN License

Digital literacy

Microsoft Office

Education

Registered Nurse License (TN)

Tools

MS Office

Email

Job description

BCBST BlueCross BlueShield of Tennessee, Inc. is hiring a Case Manager to manage complex members with significant medical and psychosocial needs, delivering care digitally and telephonically. The role emphasizes clinical judgment, utilization management, and coordination across providers and benefits programs.

The ideal candidate has an active RN license (TN or compact), 3 years of clinical experience and strong digital literacy. This remote position requires Monday–Friday 8:00 a.m.–5:00 p.m.