RN Care Manager: Elevate Patient Care & Coordination

Capital Blue Cross; Harrisburg (Dauphin County); On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Retirement plan

Paid time off

Holidays

Volunteer time off

Incentive plan

Tuition reimbursement

Job summary

Capital Blue Cross seeks a Care Manager to coordinate services for members with complex needs, emphasizing education and self-management to achieve quality, cost-effective outcomes. The role involves assessment, planning, resource coordination, progress monitoring, and thorough documentation of the case management process.

The ideal candidate is an RN with active licensure and CCM certification within two years, with experience in care management or health plan settings.

Qualifications

• RN licensed in home state; CCM within 2 years of employment.
• Experience in care management or health plan settings preferred.
• Knowledge of NCQA/CMS standards is beneficial.

Responsibilities

• Coordinates services for members meeting criteria, promoting education and self-management.
• Assess needs, develop and implement a plan of care, monitor progress.
• Collaborates with providers, families and community resources to coordinate care.
• Documents care management activities per policies and procedures.
• Identify and report quality of care issues while protecting confidentiality.
• Attend meetings and trainings as required.

Skills

Communication skills

Clinical process

Written communication

Customer service

Teamwork

PC proficiency

Education

RN license

Certified Case Manager within 2 years

Tools

Microsoft Office

Job description

Capital Blue Cross seeks a Care Manager to coordinate services for members with complex needs, emphasizing education and self-management to achieve quality, cost-effective outcomes. The role involves assessment, planning, resource coordination, progress monitoring, and thorough documentation of the case management process.

The ideal candidate is an RN with active licensure and CCM certification within two years, with experience in care management or health plan settings.