Remote Medicare Case Manager: Expert Care Coordination

Blue Cross and Blue Shield of North Carolina; Indiana; À distance; USD 74 000 - 118 000; Plein temps

Avantages offerts par ce poste

Medical, dental, and vision coverage

Parental leave and surrogacy support

401k match with company contribution

Tuition reimbursement / Career dev

Résumé du poste

Blue Cross NC is hiring a Case Manager for Medicare Case Management. You’ll coordinate care, assess needs, and develop member-centric plans, working with a multidisciplinary team to achieve optimal outcomes.

The role emphasizes collaboration with members, families, and providers, and requires an active RN license and 3 years of case management experience. Remote flexibility is offered with some in-office visits.

Qualifications

• RN with 3 years of clinical and/or case management experience required.
• Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure) to perform described job duties.
• For some roles, additional specialty certification (i.e. CCM, CDCES) may be required. If so, incumbents must obtain relevant certification within 2 years of employment.

Responsabilités

• Coordinate care, resources and/or services for members on a multidisciplinary team.
• Perform comprehensive assessments to determine collaboration with members, families, and providers on plans for treatment and discharge planning.
• Develop member-centric plans tailored to health needs and support levels; identify barriers to goals.
• Utilize community resources and funding in plan development.
• Monitor and manage member progress with follow-ups and documentation.
• Evaluate care across the continuum of care (office, hospital, SNF, home health).
• Educate members to promote proactive care and cost-effective outcomes.
• Document all aspects of the care plan from assessment to evaluation.

Connaissances

Care Plan Development

Care Planning

Clinical Outcomes

Health Care

Healthcare Utilization Management

Nursing Fundamentals

Patient Advocacy

Patient Care

Patient Care Coordination

Patient Evaluations

Formation

RN license (NC or compact multi-state)

Description du poste

Blue Cross NC is hiring a Case Manager for Medicare Case Management. You’ll coordinate care, assess needs, and develop member-centric plans, working with a multidisciplinary team to achieve optimal outcomes.

The role emphasizes collaboration with members, families, and providers, and requires an active RN license and 3 years of case management experience. Remote flexibility is offered with some in-office visits.