Remote RN Case Manager - Care Coordination & Outcomes

Blue Cross and Blue Shield of North Carolina; Durham, Northern (NC, KY); Hybrid; USD 74,000 - 118,000; Full time

Benefits offered by this job

Medical, Dental, and Vision coverage

401k match

Paid Time Off (PTO)

Tuition reimbursement

Parental leave and adoption/surrogacy

Job summary

Blue Cross and Blue Shield of North Carolina is hiring a Case Manager to join the Commercial Case Management team. The role coordinates care, resources, and services for members to achieve optimal clinical and resource outcomes across the continuum of care.

The position supports a Hybrid Flex model with remote work and limited in-office visits, primarily based in North Carolina. A valid RN license and 3 years of experience are required, with potential CCM/CDCES certifications within two years.

Qualifications

• RN with 3 years of clinical and/or case management experience required.
• Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure).
• For some roles, CCM or CDCES certifications may be required and must be obtained within 2 years of employment.

Responsibilities

• Coordinate care, resources and/or services for members to achieve optimal clinical and resource outcomes.
• Perform comprehensive assessments to determine plans for treatment, intervention and discharge planning.
• Develop member-centric plans and identify barriers to goals; utilize community resources and funding as needed.

Skills

Care Plan Development

Care Planning

Clinical Outcomes

Health Care

Healthcare Utilization Management

Nursing Fundamentals

Patient Advocacy

Patient Care

Patient Care Coordination

Patient Evaluations

Education

RN license required

Job description

Blue Cross and Blue Shield of North Carolina is hiring a Case Manager to join the Commercial Case Management team. The role coordinates care, resources, and services for members to achieve optimal clinical and resource outcomes across the continuum of care.

The position supports a Hybrid Flex model with remote work and limited in-office visits, primarily based in North Carolina. A valid RN license and 3 years of experience are required, with potential CCM/CDCES certifications within two years.