Nurse Case Manager

Job description

The Complex Care Team at BCBST is seeking a compassionate and highly skilled RN Case Manager to support members with advanced and multifaceted healthcare needs. In this role, you will provide comprehensive, member-centered care for individuals with complex and chronic conditions, including high-risk diagnoses, through a proactive, advocacy-driven approach. You will collaborate across multidisciplinary teams to coordinate care, reduce barriers, and improve health outcomes while supporting cost-effective utilization of services. Success in this position requires the ability to manage a dynamic caseload with strong critical thinking, attention to detail, and exceptional telephonic and digital communication skills. Ideal candidates will bring demonstrated experience in case management or acute care settings such as ICU, Med-Surg, Oncology, or Home Health, along with strong technical proficiency and a willingness to leverage enterprise-approved digital and AI tools to enhance care delivery and operational efficiency. Note: Although we are based in Chattanooga, TN, this is a fully remote role. Sponsorship is not available for this position.

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.

Requirements

• License: 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. Experience 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 Skills\Certifications: Excellent oral and written communication skills PC Skills required (Basic Microsoft Office and E-Mail) N/a

About BlueCross BlueShield of Tennessee

As Tennessee's largest health plan, we've been helping Tennesseans find their own unique paths to good health for more than 70 years. More than that, we're your neighbors and friends – fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow. Our mission is simple: peace of mind through better health. We're an independent, not-for-profit, locally governed health plan company – meaning we live and work alongside our Tennessee business customers and plan members. Our 6,000 employees across the state have built our strong reputation for integrity, excellent service and community leadership. But we are also part of the BlueCross BlueShield Association, a nationwide association of health care plans. Because of this, our plan members have access to the same quality health benefits while traveling or living out of state that they have while in Tennessee.