RN Case Manager: Remote Care Coordinator for Outcomes

Excellus BCBS; City of Binghamton (NY); Hybrid; USD 62,000 - 118,000; Full time

Job summary

Excellus BCBS is seeking a Case Manager to conduct case management activities in line with NYS DOH, CMS, NCQA, and other accreditation standards. You will assess members, educate, coach, and coordinate care with providers and community resources to achieve optimal and cost-effective health outcomes.

You will collaborate with interdisciplinary teams to develop comprehensive care plans, identify key interventions, and ensure adherence to regulatory requirements across Medicare, Medicaid, and other

Qualifications

• Associates degree or higher required; RN, RD, or PT licensure preferred.
• Minimum of three years of clinical experience; case management experience preferred.
• Proficiency with Microsoft Office Suite.
• Experience interpreting managed care benefit plans; knowledge of Medicare/Medicaid benefits preferred.
• Strong written and verbal communication skills; ability to multitask.

Responsibilities

• Lead and coordinate case management activities per CM policies and standards.
• Collaborate with physicians and healthcare providers to develop interdisciplinary care plans.
• Identify member needs, educate and support members; coordinate services.

Skills

NYS RN licensure

Clinical CM experience

MS Office proficiency

Managed care knowledge

Communication skills

Multitasking ability

Independent work

Case management cert

Healthcare coordination

Leadership ability

Education

Associates degree

Bachelor’s degree

Job description

Excellus BCBS is seeking a Case Manager to conduct case management activities in line with NYS DOH, CMS, NCQA, and other accreditation standards. You will assess members, educate, coach, and coordinate care with providers and community resources to achieve optimal and cost-effective health outcomes.

You will collaborate with interdisciplinary teams to develop comprehensive care plans, identify key interventions, and ensure adherence to regulatory requirements across Medicare, Medicaid, and other