RN Behavioral Health Case Manager — Care Coordination

Brighton Health Plan Solutions; Chapel Hill (NC); On-site; USD 75,000 - 110,000; Full time

Job summary

Brighton Health Plan Solutions (BHPS) is seeking a Registered Nurse for integrated case management in North Carolina. The role reports to the Supervisor, Case Management (LCSW) with dotted-line guidance from the Senior Director, Case Management (RN).

You will assess, plan, coordinate, and monitor member care across the healthcare continuum to improve outcomes and cost-effectiveness. The position emphasizes adherence to NCQA standards, HIPAA compliance, and collaboration with providers,

Qualifications

• Active RN license in good standing
• Compact multistate licensure required; NY license preferred
• BSN preferred; ADN with relevant experience acceptable
• 2+ years in nursing with case management or care management
• Experience in behavioral health or integrated care preferred
• Knowledge of NCQA standards and HIPAA requirements
• Strong communication, organization, and multitasking skills
• Proficiency with EMR and clinical documentation systems

Responsibilities

• Conduct comprehensive assessments across medical, behavioral health, psychosocial needs
• Develop and update member-centered care plans with interdisciplinary teams
• Coordinate care across the healthcare continuum for quality outcomes
• Educate members and caregivers on conditions, treatment plans, and self-management
• Identify barriers to care and engage resources to improve adherence
• Facilitate transitions of care and timely access to services
• Document assessments, plans, and progress in EMR per standards
• Support quality improvement and accreditation activities
• Collaborate with Utilization Management and Medical Directors

Skills

Clinical assessment

Care planning

Interdisciplinary teamwork

Communication

Problem solving

Care coordination

Documentation

HIPAA compliance

Education

BSN preferred

ADN with relevant experience

Tools

Microsoft Office

EMR systems

Case management databases

Job description

Brighton Health Plan Solutions (BHPS) is seeking a Registered Nurse for integrated case management in North Carolina. The role reports to the Supervisor, Case Management (LCSW) with dotted-line guidance from the Senior Director, Case Management (RN).

You will assess, plan, coordinate, and monitor member care across the healthcare continuum to improve outcomes and cost-effectiveness. The position emphasizes adherence to NCQA standards, HIPAA compliance, and collaboration with providers,