Remote RN Case Manager & Health Coach

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

Health, dental, and vision coverage

Parental leave and surrogacy/adoption

Tuition reimbursement

401k with company match

Paid Time Off

Job summary

Blue Cross NC is hiring a Case Manager to join the Commercial Case Management team. You will coordinate care, resources and services for members to achieve optimal outcomes and collaborate with the healthcare team to ensure appropriate plans and discharge needs.

The ideal candidate is an RN with 3 years of clinical or case management experience and a valid NC or compact license. The role offers a Hybrid-Flex/Remote-Flex arrangement with a strong total rewards package and professional development

Qualifications

• RN with 3 years of clinical and/or case management experience.
• Must have a valid NC or compact multi-state RN license.
• Some roles may require CCM or CDCES certification within 2 years of hire.
• Blue Cross NC will not sponsor employment authorization.

Responsibilities

• Coordinate care, resources and services for members to achieve optimal clinical and resource outcomes.
• Perform comprehensive assessments to determine plans for treatment, intervention and discharge.
• Develop member-centric plans addressing health status and support needs, identifying barriers.
• Utilize community resources and funding sources in the plan of care.
• Monitor and manage the member's progress with appropriate follow-ups and referrals.
• Document all aspects of the plan from initial assessment to outcome evaluation.
• Outreach to high-risk or high-cost members as needed.

Skills

Care plan development

Care planning

Clinical outcomes

Healthcare utilization management

Nursing fundamentals

Patient advocacy

Patient care coordination

Patient evaluations

Patient care

Education

RN license (NC or compact)

Job description

Blue Cross NC is hiring a Case Manager to join the Commercial Case Management team. You will coordinate care, resources and services for members to achieve optimal outcomes and collaborate with the healthcare team to ensure appropriate plans and discharge needs.

The ideal candidate is an RN with 3 years of clinical or case management experience and a valid NC or compact license. The role offers a Hybrid-Flex/Remote-Flex arrangement with a strong total rewards package and professional development