Remote Medicare Case Manager - Care Coordination Pro

Blue Cross NC; North Carolina; Remote; USD 74,000 - 118,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

401k match

PTO

Parental leave

Adoption assistance

Surrogacy assistance

Job summary

Blue Cross NC in North Carolina is seeking a Case Manager to join the Medicare Case Management team. You’ll coordinate care, resources and services for members, perform comprehensive assessments, and collaborate with families, providers and internal partners to develop treatment plans that promote effective utilization and positive outcomes.

You’ll document progress, monitor plans, address barriers, and educate members to support proactive, cost-conscious care.

Qualifications

• RN with 3 years of clinical and/or case management experience.
• Must have and maintain a valid RN license (NC or compact multi-state) to perform described job duties.
• Some roles may require CCM or CDCES certification within 2 years of employment.
• Blue Cross NC will not sponsor employment authorization for this position.
• Bonus points for telephonic/remote case management experience.

Responsibilities

• Serve on a multidisciplinary team coordinating care, resources and/or services for members to achieve optimal outcomes.
• Perform comprehensive assessments to determine collaboration with members, families and providers on care plans.
• Develop member-centric plans addressing health status, education and support needs.
• Monitor and manage plans with follow-ups, referrals and documentation.
• Educate members to promote proactive intervention and cost-effective care.
• Document all aspects of the plan from assessment to evaluation of outcomes.

Skills

Care Plan Development

Care Coordination

Clinical Outcomes

Nursing Fundamentals

Patient Advocacy

Health Care

Utilization Management

Patient Care

Patient Evaluations

Education

RN license

Job description

Blue Cross NC in North Carolina is seeking a Case Manager to join the Medicare Case Management team. You’ll coordinate care, resources and services for members, perform comprehensive assessments, and collaborate with families, providers and internal partners to develop treatment plans that promote effective utilization and positive outcomes.

You’ll document progress, monitor plans, address barriers, and educate members to support proactive, cost-conscious care.