Remote Medicare Case Manager: Care Coordinator

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

Benefits offered by this job

Medical, dental, vision coverage

401k match

Tuition reimbursement

Job summary

Blue Cross NC is seeking a Case Manager to coordinate care and resources for Medicare members. The role emphasizes multidisciplinary collaboration, documentation, and proactive planning to improve outcomes and resource utilization.

Responsibilities include assessing members, developing tailored care plans, coordinating with providers, and guiding patients through treatment and discharge while maintaining thorough documentation. Remote flexibility is noted.

Qualifications

• RN with 3 years of clinical and/or case management experience required.
• Valid clinical license (NC or compact multi-state licensure) to perform duties.
• Some roles may require CCM or CDCES certification within 2 years of employment.

Responsibilities

• Coordinate care, resources and services to achieve optimal clinical outcomes.
• Perform comprehensive assessments to plan treatment and discharge.
• Develop member-centric plans addressing needs, status and support level.
• Utilize community resources and funding in care planning.
• Monitor and manage member progress with appropriate follow-up and referrals.
• Evaluate care across settings (office, hospital, home, etc.).
• Educate members to promote positive outcomes and reduce costs.
• Document plans and ongoing outcomes from assessment to evaluation.

Skills

Case management experience

Licensure (NC or multi-state)

Certifications (CCM or CDCES) optional

Education

RN licensure

Job description

Blue Cross NC is seeking a Case Manager to coordinate care and resources for Medicare members. The role emphasizes multidisciplinary collaboration, documentation, and proactive planning to improve outcomes and resource utilization.

Responsibilities include assessing members, developing tailored care plans, coordinating with providers, and guiding patients through treatment and discharge while maintaining thorough documentation. Remote flexibility is noted.