Remote RN Case Manager: Care Coordination & Outcomes

your Jared; Northern (KY); Hybrid; USD 65,000 - 85,000; Full time

Benefits offered by this job

Subsidized health plans

401k retirement savings with company‑m

Life Insurance

Paid Time Off

Educational Assistance

Service Recognition

Employee discounts

Job summary

BlueCross BlueShield of South Carolina is hiring a Case Management Coordinator for a fully remote role in South Carolina. The position emphasizes care management, coordination of services, and patient advocacy to improve outcomes and cost-effectiveness.

The candidate will assess needs, develop action plans, monitor progress, and maintain clear documentation while communicating with members and providers. RN or related licensure is required, with URAC/NLC credentials prioritized.

Qualifications

• Associates degree required in a related field.
• RN license or related licensure in the state of hire or NLC compacts.
• 4 years of recent clinical experience or 4 years in utilization review/case management with 2 clinical years.

Responsibilities

• Provide active care management and develop action plans with members.
• Coordinate services, monitor plans, and evaluate outcomes and medical necessity.
• Offer telephonic support for members with chronic or high-risk conditions.
• Educate members and providers about care delivery, networks, and benefit plans.
• Maintain documentation and ensure compliance with regulations.

Skills

Word processing software

Education

Associates in a job-related field

Graduate of Accredited School of Nursing or 2 years job related work experience

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is hiring a Case Management Coordinator for a fully remote role in South Carolina. The position emphasizes care management, coordination of services, and patient advocacy to improve outcomes and cost-effectiveness.

The candidate will assess needs, develop action plans, monitor progress, and maintain clear documentation while communicating with members and providers. RN or related licensure is required, with URAC/NLC credentials prioritized.