Note: The job is a remote job and is open to candidates in USA. BlueCross BlueShield of Tennessee (BCBST) is seeking a skilled and compassionate Registered Nurse with a strong background in case management to join their fast‑paced, high‑performing team. The role focuses on supporting members with acute care needs and chronic health conditions, ensuring they receive timely, coordinated, and effective care.
Responsibilities
- Supporting utilization management functions for more complex and non-routine cases as needed
- Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs
- Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits
- Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation
- Digital positions must have the ability to effectively communicate via digital channels and offer technical support
- Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions
- Various immunizations and/or associated medical tests may be required for this position
- This job requires digital literacy assessment
Skills
- Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law
- 3 years - Clinical experience required
- 5 years - Experience in the health care industry
- For Select Community & Katie Beckett: 2 years experience in IDD for Select Community is required
- Excellent oral and written communication skills
- PC Skills required (Basic Microsoft Office and E-Mail)
- Prior experience in health insurance and telephonic member engagement
- FEP experience as a valuable plus
- A Certified Case Manager (CCM) credential is highly preferred
Company Overview
As Tennessee's largest health plan, we've been helping Tennesseans find their own unique paths to good health for more than 70 years. It was founded in 1945, and is headquartered in Chattanooga, Tennessee, USA, with a workforce of 5001-10000 employees. Its website is http://www.bcbst.com.
