Case Manager

🕒 vor 4 Tagen

🌲 North Carolina – Remote

infoinfo

💵 $73.698 - $117.917 / Jahr

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

👔 Manager

👻 Geisterscore 0%

infoinfo

🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of Blue Cross NC

Blue Cross NC

5001 - 10000 Mitarbeiter

Gegründet 1933

🏥 Gesundheitswesen

🛡️ Versicherung

⚕️ Krankenversicherung

Healthcare • Insurance • Healthcare Insurance

Blue Cross NC ist ein Krankenversicherungsanbieter, der eine Vielzahl von Gesundheitsplänen und -diensten für Einzelpersonen und Gruppen anbietet. Das Unternehmen konzentriert sich darauf, Qualitäts-Gesundheitsversorgung bereitzustellen und die Gesundheitsergebnisse für seine Mitglieder durch innovative Gesundheitsprogramme und -dienste zu verbessern. Blue Cross NC hat sich verpflichtet, den Zugang zu erschwinglicher Gesundheitsversorgung zu verbessern und gleichzeitig die Gesundheit und das Wohlbefinden der Gemeinschaften, denen es dient, zu unterstützen.

Beschreibung

• Coordinate care, resources, and/or services for selected member populations • Provide guidance and promote effective utilization and monitoring of health care resources • Collaborate with healthcare team members to achieve optimal clinical and resource outcomes • Perform comprehensive assessments and coordinate treatment, interventions, and discharge planning • Develop member-centric plans of care and identify barriers to goals • Utilize community resources and funding sources • Monitor and manage members through follow-up, education, referrals, documentation, and plan modifications • Evaluate and facilitate care across the continuum, including physician offices, hospitals, rehabilitation units, skilled nursing facilities, and home care • Educate members and encourage proactive intervention • Document assessments, plans, implementation, monitoring, and outcomes • Potentially outreach to high-risk, high-cost, or high-utilization members • Potentially review alternative treatment plans, benefits exceptions, and flex benefit options • Potentially evaluate medical necessity and service appropriateness • Develop policies, procedures, education, or training as needed

🎯 Anforderungen

• RN with 3 years of clinical and/or case management experience required • Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure) • For some roles, additional specialty certification (i.e. CCM, CDCES) may be required; relevant certification must be obtained within 2 years of employment if applicable • At this time, Blue Cross NC will not sponsor employment authorization for this position • Holding one or more additional non-compact state nursing licenses is strongly preferred • Broad clinical nursing experience across multiple care settings is highly desirable

🏖️ Vorteile

• Work-life balance, flexibility, and autonomy • Medical, dental, and vision coverage • Health and wellness programs • Parental leave and support • Adoption and surrogacy assistance • Career development programs • Tuition reimbursement for continued education • 401k match including an annual company contribution • Annual Incentive Bonus • Paid Time Off (PTO)

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