Remote Medicare Case Manager: Care Coordination Expert

Blue Cross and Blue Shield of North Carolina; Maryland; Remote; USD 74,000 - 118,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401k match with company contribution

Parental leave and surrogacy/adoption

Job summary

Blue Cross NC is seeking a Case Manager to join the Medicare Case Management team. The role coordinates care, resources, and services for member populations, guiding utilization and monitoring to drive quality care.

You will work with a multidisciplinary team, perform assessments, develop member-centric plans, and document progress. This remote-flex role requires RN with 3 years of case management and a valid RN license.

Qualifications

• RN with 3 years of clinical and/or case management experience.
• Valid RN license (NC or compact multi-state) to perform duties.
• For some roles, CCM or CDCES may be required; obtain within 2 years.

Responsibilities

• Coordinate care, resources and services for members to achieve optimal outcomes.
• Perform comprehensive assessments and plan treatment and discharge steps.
• Develop member-centric plans and identify barriers to goals.
• Utilize community resources and funding in plan development.
• Monitor and manage member progress and adjust plans as needed.

Skills

Case management

Clinical assessment

Care coordination

Education

RN license

Compact multi-state licensure

Job description

Blue Cross NC is seeking a Case Manager to join the Medicare Case Management team. The role coordinates care, resources, and services for member populations, guiding utilization and monitoring to drive quality care.

You will work with a multidisciplinary team, perform assessments, develop member-centric plans, and document progress. This remote-flex role requires RN with 3 years of case management and a valid RN license.