Remote Oncology Case Manager - Care Coordination Leader

Southcarolinablues; South Carolina; Remoto; USD 65.000 - 90.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health insurance

401k retirement plan with companymatch

Paid Time Off (PTO)

Education Assistance

Telework/Remote work

Descrizione del lavoro

BlueCross BlueShield of South Carolina is seeking a Case Management Coordinator with an oncology focus for a remote, full-time role in South Carolina. The candidate will manage care coordination, assess service needs, and develop action plans in collaboration with members and providers.

The position requires an active US RN license (or equivalent), 4 years of clinical or utilization review experience, and strong communication skills.

Competenze

• RN license active in the United States.
• 4 years of recent clinical experience in oncology or related specialty.
• Experience in utilization review or case management preferred.

Mansioni

• Provide active care management, assess needs, and coordinate action plans with members.
• Monitor services, evaluate outcomes, and ensure medical necessity criteria are met.
• Document clinical information accurately to support benefits and contract terms.
• Offer telephonic support to members with chronic or high-risk conditions.
• Educate and coach members using motivational interviewing techniques.
• Collaborate with providers, advocate for members, and promote program enrollment.
• Communicate requested services to providers and members in writing or by phone.
• Participate in data collection for claims adjudication and quality reviews.
• Maintain knowledge of contracts and network status of providers.

Conoscenze

RN license

Oncology experience

Case management

Microsoft Office

Communication skills

Analytical thinking

Formazione

Associate's degree in related field

Bachelor's degree in Nursing preferred

Strumenti

Microsoft Office

Descrizione del lavoro

BlueCross BlueShield of South Carolina is seeking a Case Management Coordinator with an oncology focus for a remote, full-time role in South Carolina. The candidate will manage care coordination, assess service needs, and develop action plans in collaboration with members and providers.

The position requires an active US RN license (or equivalent), 4 years of clinical or utilization review experience, and strong communication skills.