RN Care Manager: Telephonic Care Coordination Lead

Blue Cross Blue Shield of Michigan; Michigan; On-site; USD 75,000 - 95,000; Full time

Job summary

Blue Cross Blue Shield of Michigan is seeking a Care Manager RN to lead a multidisciplinary team and coordinate a holistic care management program for a diverse member population. The role operates across telephonic and digital channels, acting as the single point of contact for members, caregivers, and providers.

You will assess health, psychosocial needs, and cultural preferences, develop individualized care plans, arrange resources, and monitor outcomes.

Qualifications

• Nursing diploma or ASN required.
• BSN strongly preferred.
• 3 years of clinical nursing experience required.
• 1 year of case management experience in a managed care setting preferred.
• Active Michigan RN license required.
• CCM certification required or to be obtained within 18 months of hire.
• CCP certification preferred.
• Experience managing patients telephonically and via digital channels preferred.

Responsibilities

• Lead coordination of a multidisciplinary team to provide holistic care to meet member needs telephonic and/or digitally.
• Assess the member's health, psychosocial needs, cultural preferences, and support systems.
• Engage the member and/or caregiver to develop an individualized plan of care, address barriers, identify gaps in care, and promotes improved overall health outcomes.
• Arrange resources necessary to meet identified needs (e.g., community resources, mental health services, substance abuse services, financial support services and disease-specific services).
• Coordinate care delivery and support among member support systems, including providers, community-based agencies, and family.
• Advocate for members and promote self-advocacy.
• Deliver education to include health literacy, self-management skills, medication plans, and nutrition.
• Monitor and evaluate effectiveness of the care management plan, assess adherence to care plan to ensure progress to goals and adjust and reevaluate as necessary.
• Accurately document interactions that support management of the member.
• Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to support continuity of care.
• Educate the member and/or caregiver about post-transition care and needed follow-up, summarizing what happened during an episode of care.
• Secure durable medical equipment and transportation services and communicate this to the member and/or caregiver and to key individuals at the receiving facility or home care agency.
• Adhere to professional standards as outlined by protocols, rules and guidelines meeting quality and production goals
• Continue professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM)

Skills

Empathetic listening

Motivational interviewing

Time management

Interpersonal skills

Care coordination

Multidisciplinary teamwork

Digital communication

Documentation

Microsoft Office

Teamwork

Education

Nursing diploma or ASN

BSN preferred

Tools

Microsoft Office

Job description

Blue Cross Blue Shield of Michigan is seeking a Care Manager RN to lead a multidisciplinary team and coordinate a holistic care management program for a diverse member population. The role operates across telephonic and digital channels, acting as the single point of contact for members, caregivers, and providers.

You will assess health, psychosocial needs, and cultural preferences, develop individualized care plans, arrange resources, and monitor outcomes.