Remote RN Case Management Supervisor - Lead Care Programs

Southcarolinablues; Northern (KY); Hybrid; USD 85,000 - 110,000; Full time

Job summary

BlueCross BlueShield of South Carolina is seeking a Case Management Supervisor to oversee daily functions of Utilization Review, Case Management, Medical Review, and related programs. Remote role with potential on-site training.

Requires RN licensure or equivalent and 5 years of health-related experience, plus leadership capabilities. The position emphasizes data collection, reporting, and ensuring URAC/NCQA compliance across programs, with responsibilities spanning staff development and program

Qualifications

• Associate degree in a related field or nursing degree equivalency.
• RN licensure or equivalent license required.
• 5 years health promotion/health education/health insurance/clinical experience; leadership role 1 year.
• Strong communication, analytical, and data reporting skills.

Responsibilities

• Supervise day-to-day activities of assigned staff.
• Identify training needs of staff.
• Verify accuracy, efficiency, and effectiveness of workflow functions.
• Develop and oversee specialty programs (wellness, preventive, employer work site).
• Supervise staff including time/leave approvals and performance reviews.
• Prepare weekly/monthly management reports and oversee data collection.

Skills

Insurance knowledge

Managed care

Communication skills

Leadership

Data analysis

Problem solving

Education

Associate degree or equivalent

Nursing degree equivalency

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a Case Management Supervisor to oversee daily functions of Utilization Review, Case Management, Medical Review, and related programs. Remote role with potential on-site training.

Requires RN licensure or equivalent and 5 years of health-related experience, plus leadership capabilities. The position emphasizes data collection, reporting, and ensuring URAC/NCQA compliance across programs, with responsibilities spanning staff development and program