RN Care Manager

🕒 June 3

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $28 - $53 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Capital Blue Cross

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1938

⚕️ Healthcare Insurance

💸 Finance

👥 B2C

Healthcare Insurance • Finance • B2C

Capital Blue Cross is a health insurance company that offers a range of health plans for individuals, families, and employers. They serve customers in Central Pennsylvania and the Lehigh Valley, focusing on providing health coverage services such as Medicare plans, student health plans, and resources for managing medical care. Capital Blue Cross positions itself as a partner in health, emphasizing support for members' overall wellness and preventive health measures.

📋 Description

• The Care Manager is responsible for the coordination of services for members who meet established criteria, with an emphasis on education/self-management and promoting quality care and cost-effective outcomes. • Uses a collaborative process to assess Member needs and develop and implement a plan of care. • Coordinates resources, monitors progress, evaluates Member status, and fully documents the individualized member care management process and outcomes. • Provides counseling and referrals to community/local/state programs; collaborates with caregivers, providers, community agencies, behavioral health, and other resources to coordinate care to achieve member’s optimal health status. • Responsible for the management and oversight of a caseload of moderate - high risk Members with complex medical/behavioral/psychosocial needs.

🎯 Requirements

• At least three (3) years’ recent/related experience; care management, home health, medical/surgical behavioral health, and/or critical care preferred. • Health plan experience preferred. • Additional experience related to specialized positions (Oncology, Transplant, Maternity, Behavioral Health) will also be considered. • Experience in health coaching and motivational interviewing techniques preferred. • Registered Nurse with active licensure in home state; additional state’s licensure as needed/required to meet customer needs • Compact RN license preferred • Certified Case Management certification within 2 years of employment.

🏖️ Benefits

• Medical, Dental & Vision coverage • Retirement Plan • Generous time off including Paid Time Off • Holidays • Volunteer time off • Incentive Plan • Tuition Reimbursement