Registered Nurse (RN) Medical Case Manager

Job overview

The Registered Nurse (RN) Medical Case Manager role is described as remote, with the listing associated with Chattanooga, TN. Compensation is not specified. The High-Cost Claim team supports members with advanced and multifaceted healthcare needs. The nurse provides proactive, member-centered case management for people with complex and chronic conditions. By assessing needs, coordinating care across members and providers, and monitoring interventions, the role aims to improve health outcomes, reduce barriers, and support appropriate use of healthcare services.

What you'll do

• Support utilization management for complex and non-routine cases as needed
• liaise among members, providers, and internal or external customers
• oversee highly complex cases and implementation of interventions
• perform case management assessment, planning, implementation, coordination, monitoring, outcomes, and evaluation
• communicate through digital channels and provide technical support in digital positions.

What we're looking for

Skills & competencies

registered nurse

rn

medical case manager

case management

high-cost claims

care coordination

complex care

chronic conditions

remote

chattanooga tn

volunteer state health plan

Work arrangement

• Weekend coverage required

Why this role

Requires an active Tennessee RN license or a license in the nurse's state of residence if that state participates in the Nurse Licensure Compact. Requires three years of clinical experience and five years in the healthcare industry.

About the employer

BlueCross BlueShield of Tennessee is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.