Remote Medicare Case Manager: Care Coordination Pro

Blue Cross NC; Durham (NC); Remote; USD 74,000 - 118,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Parental leave

401(k) with company match

Career development & tuition support

Job summary

Blue Cross NC is seeking a Case Manager to join the Medicare Case Management team in a Remote Flex capacity. The role focuses on coordinating care and services for members, developing individualized plans, and monitoring outcomes across a range of health settings.

The position requires an RN with 3 years of case management experience and an active NC or compact license. You will work on a multidisciplinary team, educate members, document plans, and utilize community resources to optimize care

Qualifications

• RN with 3 years of clinical and/or case management experience required.
• A valid clinical license (NC or compact multi-state licensure) is required.
• CCMS or CCM and related certifications may be preferred and must be obtained within 2 years of employment.

Responsibilities

• Coordinate care, resources and services for members to achieve optimal outcomes.
• Perform comprehensive assessments and develop member-centric plans of care.
• Monitor progress, provide education, and adjust plans as needed.
• Document all aspects of the plan through initial assessment to evaluation.
• Engage with members at high risk or high utilization as needed.

Skills

Care Plan Development

Care Planning

Clinical Outcomes

Health Care

Healthcare Utilization

Nursing Fundamentals

Patient Advocacy

Patient Care

Patient Care Coordination

Patient Evaluations

Job description

Blue Cross NC is seeking a Case Manager to join the Medicare Case Management team in a Remote Flex capacity. The role focuses on coordinating care and services for members, developing individualized plans, and monitoring outcomes across a range of health settings.

The position requires an RN with 3 years of case management experience and an active NC or compact license. You will work on a multidisciplinary team, educate members, document plans, and utilize community resources to optimize care