Remote RN Care Manager – Medicare Advantage

CareFirst BlueCross BlueShield; Baltimore (MD); Hybrid; USD 72,360 - 143,715; Full time

Job summary

CareFirst BlueCross BlueShield is seeking an experienced Registered Nurse to support Medicare Advantage from the Baltimore/DC area. The role involves researching member needs, coordinating with the care team, and ensuring a plan of care that improves outcomes while controlling costs.

Remote work is allowed with periodic on-site attendance. Qualifications include an RN license in MD/VA/DC, 5 years of relevant care management experience, and the ability to work with complex, multi-morbidity cases

Qualifications

• Education: High School Diploma or GED is required.
• Preferred: Bachelors degree in nursing (BSN).
• RN state licensure in MD, VA or DC.
• 5 years clinically related experience in Care Management or related fields.

Responsibilities

• Identify members with acute/complex medical or behavioral health conditions and develop a comprehensive plan of care.
• Collaborate with interdisciplinary care team to monitor and update plan of care, ensuring alignment with benefits and policies.

Skills

Clinical standards

Communication skills

Time management

Typing / data entry

Web-based platforms

Microsoft Office

Education

HS Diploma or GED

BSN preferred

Tools

Web-based platforms

Microsoft Office

Job description

CareFirst BlueCross BlueShield is seeking an experienced Registered Nurse to support Medicare Advantage from the Baltimore/DC area. The role involves researching member needs, coordinating with the care team, and ensuring a plan of care that improves outcomes while controlling costs.

Remote work is allowed with periodic on-site attendance. Qualifications include an RN license in MD/VA/DC, 5 years of relevant care management experience, and the ability to work with complex, multi-morbidity cases