RN Case Manager

BCBSM; Eagan (MN); Remote; USD 69,000 - 114,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Life insurance

401k

PTO

VPTO

Job summary

Blue Cross and Blue Shield of Minnesota is seeking an RN Case Manager to provide telephonic support to members, perform assessments, identify gaps in care, and develop individualized care plans. The role coordinates referrals and helps members understand their benefits, without delivering direct clinical care.

You will conduct outreach using motivational interviewing, document findings, collaborate with providers, and participate in audits and team meetings.

Qualifications

• 3+ years of related case management (clinical) professional experience.
• Bachelor's degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted. Flexibility to work varied hours.

Responsibilities

• Provide telephonic engagement to encourage participation and support.
• Develop and monitor individualized care plans with follow-up actions.
• Coordinate referrals and connect members to in-network providers.
• Navigate multiple systems and update case documentation.
• Participate in client/vendor audits and defend actions.
• Mentor and shadow new hires.
• Address privacy concerns and collaborate with Member Services.

Skills

Tailor communication

Active listening

Time management

Analytical thinking

Education

Bachelor's degree

Job description

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

The Impact You'll Have

The RN Case Manager provides telephonic support to members with health needs by conducting assessments, identifying gaps in care, and developing individualized care plans. This role coordinates referrals, connects members to community and in-network providers, and helps members understand their benefits, ensuring comprehensive support without delivering direct clinical care.

What You'll Do

Provide telephonic engagement only, using motivational interviewing and therapeutic techniques to encourage participation. Manage a mix of new cases and follow-up calls, ensuring timely and effective support.

Develop and monitor individualized care plans, setting follow-up actions and goals.

Navigate multiple systems to gather relevant information and update case documentation.

How You'll Do It

Review member information and prepare for outreach calls to conduct clinical assessments and document findings.

Research, place referrals and coordinate with providers to connect members to appropriate resources and services, following up to ensure receipt and follow through.

Participate in clinical rounds and team meetings to review cases, receive feedback, and ensure best practices.

Prepare for and present cases during client or vendor audits, defending actions taken and responding to inquiries.

Navigate complex member situations, including privacy issues due to family dynamics, by collaborating with Member Services to resolve concerns while maintaining ongoing support for the member.

Consult with team members to ensure best practices, participate in required training, and assist with specialty projects; frequently mentor and provide shadowing opportunities for new hires.

Performs additional responsibilities consistent with the scope and level of the role, as assigned.

Required Skills & Experience

3+ years of related case management (clinical) professional experience.

Bachelor's degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted. Flexibility to work varied hours.

Preferred Skills & Experience

Ability to tailor communication to varied audiences, actively listen to uncover requirements, and ensure accurate and timely information exchange.

Capacity to analyze information, identify patterns and root causes, and collaborate with partners to implement practical solutions.

Competence in leveraging technology to tailor communications to varied audiences, listen to uncover needs, analyze root causes, and collaborate on practical solutions.

Ability to effectively organize work, balance competing priorities and manage time across multiple responsibilities and deadlines.

Licensure/Certifications

MN RN License

Role Designation

Teleworker

Role designation definition:

Teleworking is working full time remote.

Hybrid is a minimum of 2 days onsite.

Onsite is full-time onsite.

Compensation and Benefits

$68,900.00 - $91,300.00 - $113,700.00 Annual

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

To discover more about what we have to offer, please review our benefits page .

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affi… (truncated)

Physical requirements.