Remote RN Case Manager — Care Coordination

Arkansas Blue Cross Blue Shield; Idaho; Remote; USD 73,000 - 93,000; Full time

Job summary

Arkansas Blue Cross Blue Shield is seeking a Nurse Case Manager to optimize patient care and resource use. The role covers assessment, planning, coordination, and evaluation of care plans to ensure quality outcomes and cost efficiency across multiple settings.

Requirements include an active RN license, case management certification (CCM/ACM/RN-BC) or URAC recognition within 3 years, and at least four years of clinical practice in case management or related areas.

Qualifications

• RN license in good standing in the state(s) where job duties are performed required.
• Case management certification required (CCM/ACM/RN-BC) or URAC recognized within 3 years of hire.
• Minimum four years' clinical practice experience in case management or related areas.

Responsibilities

• Assess, plan, implement, coordinate, monitor, and evaluate care options to meet health needs; optimize cost effectiveness.
• Other duties as assigned.
• Practice nursing within licensure and comply with URAC standards and state regulations.
• Provide disease-specific education and stay updated on medical procedures and contracts.
• Serve as liaison with patients, families, physicians, discharge planners, home care providers and others.
• Proactively manage referrals and maintain a timely patient caseload.

Skills

Admin Process

Affinite CM

Affinite UM

CCI Edits

Collab Communications

Critical Reasoning

Cross-Functional Planning

CRM

Customer Service

Deductive Reasoning

Five9

Info Security

Interpersonal Skills

Excel

Office

Outlook

PowerPoint

Needs Assessment

Oral Communication

Problem Sensitivity

Researching

Sound Judgement

Support Coordination

Written Communication

Education

Bachelor's degree in Nursing

Job description

Arkansas Blue Cross Blue Shield is seeking a Nurse Case Manager to optimize patient care and resource use. The role covers assessment, planning, coordination, and evaluation of care plans to ensure quality outcomes and cost efficiency across multiple settings.

Requirements include an active RN license, case management certification (CCM/ACM/RN-BC) or URAC recognition within 3 years, and at least four years of clinical practice in case management or related areas.