Remote RN Case Manager — Care Coordination Pro

Excellus BCBS; City of Rochester (NY); Vor Ort; USD 62.000 - 118.000; Vollzeit

Zusammenfassung

Excellus BCBS in Rochester, NY is seeking a Case Management professional to lead and coordinate member care across a multi-disciplinary team. You will apply CMSA/NCQA standards, assess needs, educate members, develop comprehensive care plans, and monitor outcomes to improve quality and cost-effectiveness.

Level I–III positions require clinical licensure (RN, Dietitian, or PT for relevant lines), a degree, and strong communication. Remote work options may be considered case-by-case.

Qualifikationen

• Associates degree required; Bachelor’s preferred.
• Active NYS RN, Registered Dietitian, or Physical Therapist licensure required where applicable.
• Minimum of three years of clinical experience; CM experience preferred.
• Proficiency with Microsoft Office Suite.
• Experience interpreting managed care benefits; strong communication skills.

Aufgaben

• Identify and manage case identification, opening, assessment, and care planning.
• Collaborate with providers and care teams to educate and coordinate services.
• Develop and monitor interdisciplinary care plans; adjust as needed.
• Ensure compliance with NYS DOH, CMS, NCQA, and other standards.
• Maintain confidentiality and document effectively in systems.

Kenntnisse

Strong written and verbal

Multitasking

Independent work

Team collaboration

Ausbildung

Associates degree

Bachelor’s degree

Tools

Microsoft Office Suite

Case management software

Jobbeschreibung

Excellus BCBS in Rochester, NY is seeking a Case Management professional to lead and coordinate member care across a multi-disciplinary team. You will apply CMSA/NCQA standards, assess needs, educate members, develop comprehensive care plans, and monitor outcomes to improve quality and cost-effectiveness.

Level I–III positions require clinical licensure (RN, Dietitian, or PT for relevant lines), a degree, and strong communication. Remote work options may be considered case-by-case.