Remote RN Case Manager - Medicare Care Coordination

Blue Cross and Blue Shield of North Carolina; Kentucky; Remote; USD 74,000 - 118,000; Full time

Benefits offered by this job

Work-life balance

Flexibility and autonomy to do great,;

Medical, dental and vision coverage

Parental leave and adoption support

Career development and tuitionReim

Job summary

Blue Cross NC is hiring a Case Manager to join the Medicare Case Management team. This remote-flex role coordinates care and resources for members, conducts comprehensive assessments, and develops member-centered plans. Licensure in NC or compact state is required; CCM/CDCES certifications may be needed within 2 years.

The position offers work-life balance, flexibility, and a strong benefits package, with salaries typically near mid-market levels and sponsorship not provided at this time.

Qualifications

• RN with 3 years of clinical and/or case management experience.
• Valid and applicable clinical license (NC or compact multi-state licensure).
• Some roles may require CCM or CDCES certification within 2 years.

Responsibilities

• Serve as a team member on a multidisciplinary team, coordinating care, resources and/or services for members to achieve optimal clinical and resource outcomes.
• Utilize applicable clinical skillset and perform comprehensive assessments to determine how to best collaborate with members, family, internal partners and external services/providers on plans for treatment, appropriate intervention and/or discharge planning.
• Develop a member-centric plan tailored to members' needs, health status and level of support needs; identify barriers to meeting goals or plan of care.
• Utilize community resources and funding sources as needed in the development of the plan of care.
• Perform ongoing monitoring and management of member with follow-ups, discussions of plan, referrals and documentation to assess progress toward goals.
• Educate members and encourage pro-active intervention to limit expense and encourage positive outcomes.
• Effectively document all aspects of the plan from the initial assessment to evaluation of outcome.

Job description

Blue Cross NC is hiring a Case Manager to join the Medicare Case Management team. This remote-flex role coordinates care and resources for members, conducts comprehensive assessments, and develops member-centered plans. Licensure in NC or compact state is required; CCM/CDCES certifications may be needed within 2 years.

The position offers work-life balance, flexibility, and a strong benefits package, with salaries typically near mid-market levels and sponsorship not provided at this time.