RN Case Manager: Care Coordination & Outcomes

Excellus BCBS; Oregon; Híbrido; USD 62.000 - 118.000; Jornada completa

Descripción de la vacante

Excellus BCBS seeks a Case Management professional to conduct program activities aligned with CMSA, NCQA, NYS DOH, CMS, and FEP accreditation standards. The role identifies members, assesses needs, educates, coordinates care, and develops comprehensive care plans with an interdisciplinary team.

The position spans Level I–III, with expanding responsibilities in complex case management, mentoring, and process improvements while ensuring cost-effective, high-quality care across the member

Formación

• Associates degree required; Bachelor's degree preferred.
• Active NYS RN or Registered Dietician or Physical Therapist licensure required.
• Minimum of three years of clinical experience required; Case Management experience preferred.
• Proficiency with the Microsoft Office Suite.

Responsabilidades

• Handles all member clinical condition management programs.
• Maintains knowledge of CMSA, NCQA, NYS DOH, CMS regulations and standards.
• Implements case management processes and coordinates care with providers.
• Maintains confidentiality and ensures data accuracy and privacy.

Conocimientos

Case management

Interdisciplinary collaboration

Regulatory compliance

Motivational interviewing

Communication skills

Educación

Associates degree

Bachelor’s degree preferred

Herramientas

Microsoft Office

Descripción del empleo

Excellus BCBS seeks a Case Management professional to conduct program activities aligned with CMSA, NCQA, NYS DOH, CMS, and FEP accreditation standards. The role identifies members, assesses needs, educates, coordinates care, and develops comprehensive care plans with an interdisciplinary team.

The position spans Level I–III, with expanding responsibilities in complex case management, mentoring, and process improvements while ensuring cost-effective, high-quality care across the member