RN Case Manager: Care Coordination & Outcomes Expert

Arkansas Blue Cross and Blue Shield; Arkansas; Hybrid; USD 65,000 - 90,000; Full time

Job summary

Arkansas Blue Cross and Blue Shield is seeking an RN Case Manager to optimize patient care and resource use. The role requires assessing, planning, implementing, coordinating, monitoring, and evaluating comprehensive care plans to meet individual health needs with a focus on quality outcomes and cost containment.

The position demands a BSN with an active RN license in the state, certification in case management, and at least four years of clinical practice in relevant areas such as case

Qualifications

• Bachelor's degree in Nursing preferred.
• RN license in good standing in the state where duties are performed.
• Case management certification required with URAC recertification within 3 years.

Responsibilities

• Assess, plan, implement, coordinate, monitor, and evaluate options and services to meet health needs.
• Maintain compliance with URAC standards and state regulations.
• Educate patients on disease-specific conditions and care plans.
• Collaborate with physicians, discharge planners, and home care providers to ensure quality and cost effectiveness.
• Manage referrals and maintain a timely patient caseload.

Skills

Administrative Process

Affinite CM

Affinite UM

CRM

Written Communication

Problem Sensitivity

Cross-Functional Planning

Interpersonal Relationship Management

Microsoft Excel

Microsoft Office

Microsoft Outlook

Microsoft PowerPoint

Education

Bachelor's degree in Nursing

Tools

Microsoft Excel

Microsoft Office

Microsoft Outlook

Microsoft PowerPoint

Five9

Job description

Arkansas Blue Cross and Blue Shield is seeking an RN Case Manager to optimize patient care and resource use. The role requires assessing, planning, implementing, coordinating, monitoring, and evaluating comprehensive care plans to meet individual health needs with a focus on quality outcomes and cost containment.

The position demands a BSN with an active RN license in the state, certification in case management, and at least four years of clinical practice in relevant areas such as case