Remote RN Case Manager: Care Coordination

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

Job summary

Arkansas Blue Cross Blue Shield is seeking an RN Case Manager to assess, plan, implement, coordinate, monitor, and evaluate care plans that meet health needs while optimizing outcomes and cost. This role focuses on quality patient outcomes and cost-effective care delivery and may cover high-acuity areas.

The RN will hold an active RN license, pursue CCM/ACM/RN-BC certification if not yet obtained, and bring at least four years of clinical case management experience.

Qualifications

• RN license active in the state(s) of practice.
• Case management certification (CCM/ACM/RN-BC) required or URAC within 3 years.
• 4+ years clinical practice in case management, home health, critical care, or related areas.

Responsibilities

• Assess, plan, implement, coordinate, monitor, and evaluate care options and services.
• Ensure compliance with URAC standards, policies, and state regulations.
• Educate patients on disease-specific conditions and care plans.
• Collaborate with families, physicians, discharge planners, and home care providers to ensure appropriate care and cost containment.

Skills

Administrative Process

Affinite CM

Affinite UM

CCI Edits

Collaborative Communications

Critical Reasoning

Cross-Functional Planning

CRM

Deductive Reasoning

Five9

Information Security

Interpersonal Relationship Management

Microsoft Excel

Microsoft Office

Microsoft Outlook

Microsoft PowerPoint

Needs Assessment

Oral Communications

Problem Sensitivity

Researching

Sound Judgment

Support Coordination

Written Communication

Education

Bachelor's degree in Nursing

Job description

Arkansas Blue Cross Blue Shield is seeking an RN Case Manager to assess, plan, implement, coordinate, monitor, and evaluate care plans that meet health needs while optimizing outcomes and cost. This role focuses on quality patient outcomes and cost-effective care delivery and may cover high-acuity areas.

The RN will hold an active RN license, pursue CCM/ACM/RN-BC certification if not yet obtained, and bring at least four years of clinical case management experience.