Remote RN Care Manager for Pediatric & Adult Care

CareFirst BlueCross BlueShield; Baltimore (MD); Hybrid; USD 72.000 - 143.000; Vollzeit

Zusammenfassung

CareFirst BlueCross BlueShield seeks an experienced Nurse Care Manager to support Adult and Pediatric members from a remote location within the greater Baltimore area. Periodic on-site meetings and trainings are required at CareFirst locations.

The role involves developing comprehensive care plans with members and families, coordinating with the interdisciplinary team, and ensuring documentation meets regulatory standards to drive optimal health outcomes and cost-effective care.

Qualifikationen

• High School Diploma or GED required.
• 5 years clinically related experience in care management, discharge coordination, home health, utilization review, disease management, or direct patient care.
• RN licensure in MD, VA or DC; active/state licensure required.

Aufgaben

• Identify members with acute/complex conditions and develop plans of care with family and care team.
• Collaborate with interdisciplinary team to address medical, behavioral, and social needs.
• Monitor and update plans to reflect stabilization and member self-management.
• Document member data per CareFirst protocols and regulatory standards.

Kenntnisse

Clinical care management

Verbal and written communication

Care coordination

Ausbildung

High School Diploma or GED

Bachelor's degree in nursing

CCM/ACM certification

Jobbeschreibung

CareFirst BlueCross BlueShield seeks an experienced Nurse Care Manager to support Adult and Pediatric members from a remote location within the greater Baltimore area. Periodic on-site meetings and trainings are required at CareFirst locations.

The role involves developing comprehensive care plans with members and families, coordinating with the interdisciplinary team, and ensuring documentation meets regulatory standards to drive optimal health outcomes and cost-effective care.