Remote Maternity Case Manager

Southcarolinablues; South Carolina; On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k with company match

Life Insurance

Paid Time Off

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina seeks a Case Management Coordinator focused on maternity to coordinate care plans for members with high-risk needs. This full-time role supports members remotely within South Carolina, with on-site trainings as needed.

You will assess services, develop action plans, monitor progress, and coordinate with healthcare providers to ensure appropriate care and benefit coverage in alignment with regulatory guidelines.

Qualifications

• Associates degree in a related field or equivalent experience.
• 4 years of clinical experience in a defined specialty or 4 years of utilization review/case management.
• Active, unrestricted RN license or licensed social worker/counselor/psychologist in the U.S. or Compact license.

Responsibilities

• Provide active care management and coordinate action plans with members.
• Ensure accurate documentation supporting medical necessity and benefits.
• Advise and advocate for members, communicate with providers and families.

Skills

Word processing

Quality improvement

Contract knowledge

Independent work

Decision making

Communication skills

Analytical thinking

Education

Associates in a related field

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina seeks a Case Management Coordinator focused on maternity to coordinate care plans for members with high-risk needs. This full-time role supports members remotely within South Carolina, with on-site trainings as needed.

You will assess services, develop action plans, monitor progress, and coordinate with healthcare providers to ensure appropriate care and benefit coverage in alignment with regulatory guidelines.