Remote RN Case Manager: Care Coordination & Outcomes

Excellus BCBS; Town of De Witt (NY); On-site; USD 62,000 - 118,000; Full time

Benefits offered by this job

Remote work potential

Job summary

Excellus BCBS is seeking a Case Management professional to conduct program activities in accordance with NYS DOH, CMS, NCQA, and FEP standards. You will identify members, educate and coordinate care with providers and community resources to optimize health outcomes and cost efficiency.

The role requires cross-functional collaboration to implement member-centric interventions and develop comprehensive care plans, ensuring high-quality care and regulatory compliance.

Qualifications

• Associates degree required; bachelor’s degree preferred.
• Active NYS RN, Registered Dietitian, or Physical Therapist licensure required.
• Minimum of three years of clinical experience; case management experience preferred.
• Proficient with Microsoft Office Suite.
• Experience interpreting managed care benefit plans (Medicare/Medicaid) preferred.
• Strong written and verbal communication skills; ability to multitask.

Responsibilities

• Coordinate case management activities per department policies and accreditation standards.
• Collaborate with interdisciplinary care teams to develop comprehensive care plans.
• Educate members and caregivers about conditions and treatment options.
• Maintain confidentiality and manage information per policy.
• Ensure compliance with NYS DOH, CMS, NCQA, and other regulatory standards.

Skills

Clinical experience

Case management experience

Microsoft Office proficiency

Communication skills

Education

Associates degree required

Bachelor’s degree preferred

NYS RN/RD/PT licensure

Job description

Excellus BCBS is seeking a Case Management professional to conduct program activities in accordance with NYS DOH, CMS, NCQA, and FEP standards. You will identify members, educate and coordinate care with providers and community resources to optimize health outcomes and cost efficiency.

The role requires cross-functional collaboration to implement member-centric interventions and develop comprehensive care plans, ensuring high-quality care and regulatory compliance.