Remote RN Case Management Coordinator

001 BlueCross and BlueShield of South Carolina; South Carolina; Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Subsidized health plans

401k with company match

Life Insurance

Paid Time Off

On-site cafeterias and fitness centers

Education Assistance

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking a Case Management Coordinator to improve care coordination and reduce fragmentation across providers and settings. The role emphasizes assessment, planning, facilitation, coordination, monitoring, and advocacy for members with chronic or high-risk conditions.

The position is full-time (40 hours/week), with remote work in South Carolina and occasional on-site trainings.

Qualifications

• Associates degree in a job-related field required.
• Active RN license in the state of hire (or compact multistate license).
• URAC Case Management Certification must be obtained within 4 years of hire.
• Case Manager certification preferred.

Responsibilities

• Provide active care management and develop action plans with members.
• Monitor services and evaluate outcomes for medical necessity and benefits.
• Communicate with providers and members regarding services and care plans.
• Promote enrollment in care management and disease management programs.
• Support claims adjudication with proper documentation and compliance.

Skills

Word processing

Quality improvement

Contract language

Independence

Customer service

Organization

Presentation skills

Grammar

Communication

Negotiation

Analytical thinking

Education

Associate degree in a job-related field

Bachelor's degree in Nursing

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a Case Management Coordinator to improve care coordination and reduce fragmentation across providers and settings. The role emphasizes assessment, planning, facilitation, coordination, monitoring, and advocacy for members with chronic or high-risk conditions.

The position is full-time (40 hours/week), with remote work in South Carolina and occasional on-site trainings.