RN Behavioral Health Case Manager | Care Navigator

MagnaCare; Chapel Hill (NC); On-site; USD 75,000 - 95,000; Full time

Job summary

Brighton Health Plan Solutions (BHPS) seeks a committed RN Case Manager to lead comprehensive assessments, develop member-centered care plans, and coordinate care across the health system. You will collaborate with clinicians, caregivers, and community resources to improve outcomes while ensuring compliance with NCQA standards and HIPAA.

The role emphasizes transitions of care, documentation accuracy, and proactive care management to optimize utilization and patient experience within a dynamic

Qualifications

• Active, unrestricted RN license required.
• Compact multistate licensure required; NYS license preferred; willing to obtain NYS license within 30 days.
• BSN preferred; ADN with relevant experience considered.
• Minimum two years of nursing experience in case management or related clinical settings; behavioral health experience preferred.
• Experience in behavioral health case management, integrated care, or coordination of behavioral health services preferred.
• Strong assessment, care planning, and coordination skills.
• Knowledge of NCQA Care Management standards and regulatory requirements.
• Excellent communication and ability to engage diverse teams.
• Proficiency with Microsoft Office and EMR systems.

Responsibilities

• Conduct comprehensive assessments of medical, behavioral health, psychosocial, and care coordination needs.
• Develop, implement, monitor, and update member-centered care plans with the care team.
• Coordinate care across the healthcare continuum to promote quality outcomes and appropriate utilization.
• Provide education to members and caregivers on conditions, treatment plans, and self-management.
• Identify barriers to care and opportunities to improve outcomes and reduce avoidable utilization.
• Facilitate transitions of care and ensure timely access to services.
• Document assessments, plans, and interventions in EMR per standards.

Skills

RN licensure

Care management

Behavioral health

Interdisciplinary collaboration

Communication

Critical thinking

Adaptability

Time management

Microsoft Office

HIPAA compliance

Education

BSN preferred

ADN with experience

Compact licensure understanding

Tools

Electronic Medical Records (EMR)

Care management software

Data reporting

Job description

Brighton Health Plan Solutions (BHPS) seeks a committed RN Case Manager to lead comprehensive assessments, develop member-centered care plans, and coordinate care across the health system. You will collaborate with clinicians, caregivers, and community resources to improve outcomes while ensuring compliance with NCQA standards and HIPAA.

The role emphasizes transitions of care, documentation accuracy, and proactive care management to optimize utilization and patient experience within a dynamic