RN Case Manager: Care Coordination & Outcomes

Arkansas Blue Cross and Blue Shield; Little Rock (AR); On-site; USD 70,000 - 95,000; Full time

Job summary

Arkansas Blue Cross and Blue Shield is seeking an RN Case Manager to optimize patient care and resource use by assessing, planning, implementing, coordinating, monitoring, and evaluating comprehensive care plans. You will collaborate with families, physicians, and discharge planners to ensure high-quality outcomes while controlling costs.

The role requires an active RN license, a Bachelor's in Nursing, and case management certification or URAC certification within 3 years.

Qualifications

• Bachelor's degree in Nursing required or preferred.
• Active RN license in good standing in state of employment.
• Case management certification (CCM/ACM/RN-BC) required or URAC within 3 years.

Responsibilities

• Assess, plan, implement, coordinate, monitor and evaluate care plans to meet health needs with cost containment in mind.
• Perform in accordance with policy, procedures, URAC standards and state regulations.
• Educate on disease-specific conditions and coordinate with families, physicians and care teams.
• Stay current with medical/surgical practices, procedures and enterprise guidelines.
• Collaborate with stakeholders to promote quality and appropriate service levels.

Skills

Administrative Process

Affinite CM

Affinite UM

CCI Edits

Collaborative Communications

Critical Reasoning

Cross-Functional Planning

Customer Relationship Management (CRM)

Customer Service Workstation

Deductive Reasoning

Five9

Information Security

Interpersonal Relationship Management

Microsoft Excel

Microsoft Office

Microsoft Outlook

Microsoft PowerPoint

Needs Assessment

Oral Communications

Problem Sensitivity

Researching

Sound Judgment

Support Coordination

Written Communication

Education

Bachelor's degree in Nursing

Tools

Microsoft Excel

Microsoft Office

Microsoft Outlook

Microsoft PowerPoint

Job description

Arkansas Blue Cross and Blue Shield is seeking an RN Case Manager to optimize patient care and resource use by assessing, planning, implementing, coordinating, monitoring, and evaluating comprehensive care plans. You will collaborate with families, physicians, and discharge planners to ensure high-quality outcomes while controlling costs.

The role requires an active RN license, a Bachelor's in Nursing, and case management certification or URAC certification within 3 years.