RN Case Manager - Complex Care & Utilization

BlueCross BlueShield of Tennessee, Inc.; Chattanooga (TN); Presencial; USD 65.000 - 90.000; Jornada completa

Descripción de la vacante

BlueCross BlueShield of Tennessee, Inc. seeks an RN Case Manager to support members with complex and chronic conditions. You will coordinate care, collaborate with multidisciplinary teams, and advocate for cost-effective service utilization while reducing unnecessary ED and inpatient use.

The role requires an RN license in TN, 3 years clinical experience, and strong communication skills. Experience with discharge planning and transitions of care is valued, and MS Office/MS Teams proficiency is

Formación

• Active RN license in Tennessee or a compact state.
• 2 years experience in IDD for Select Community is required.
• 3 years of clinical experience required.
• 5 years in the health care industry preferred.
• Excellent oral and written communication skills.
• Proficiency with Microsoft Office and MS Teams.

Responsabilidades

• Support utilization management for complex, non-routine cases as needed.
• Serve as liaison between members, providers, and internal/external customers.
• Oversee highly complex cases to ensure effective interventions and efficient benefits use.
• Perform core case management activities: assessment, planning, implementation, coordination, monitoring, evaluation.
• Utilize digital channels to communicate and provide technical support.

Conocimientos

Excellent communication

Telephonic communication

Digital communication

Care coordination

Microsoft Office

Microsoft Teams

Educación

RN license in TN

Herramientas

Electronic Health Records (EHR) systems

Descripción del empleo

BlueCross BlueShield of Tennessee, Inc. seeks an RN Case Manager to support members with complex and chronic conditions. You will coordinate care, collaborate with multidisciplinary teams, and advocate for cost-effective service utilization while reducing unnecessary ED and inpatient use.

The role requires an RN license in TN, 3 years clinical experience, and strong communication skills. Experience with discharge planning and transitions of care is valued, and MS Office/MS Teams proficiency is