RN Case Manager

Arkansas Blue Cross and Blue Shield

. Assess, plan, implement, coordinate, monitor, and evaluate options and services to meet individual health needs using plan benefits and community resources .

Posted 9/28/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management, including patient assessment, care coordination, and compliance with healthcare regulations. Proficient in utilizing community resources and maintaining patient safety while providing specialized education on disease-specific conditions.

Highest-signal resume keywords

Registered Nurse (RN) LicenseCase Management CertificationClinical Practice ExperiencePatient Safety ComplianceHealthcare Delivery Trends

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementPatient AssessmentCare CoordinationCritical CareDischarge PlanningMedical/Surgical KnowledgeNeeds AssessmentProblem SensitivityResearchingSound Judgment

Soft Skills

Attention to DetailIndependenceInterpersonal Relationship ManagementOral CommunicationWritten Communication

Tools & Technologies

Affinite CMAffinite UMCustomer Relationship Management (CRM)Five9Microsoft ExcelMicrosoft OfficeMicrosoft OutlookMicrosoft PowerPoint

Certifications & Qualifications

Certified Case Manager (CCM)Accredited Case Manager (ACM)Registered Nurse–Board Certified (RN-BC)

Industry Keywords

Healthcare ComplianceURAC StandardsPatient SafetyCost ContainmentHealthcare Services

About the role

Key responsibilities & impact

Assess, plan, implement, coordinate, monitor, and evaluate options and services to meet individual health needs using plan benefits and community resources
Facilitate cost effectiveness and cost containment measures
Practice nursing within the scope of licensure and ensure compliance, appropriate level of care, and patient safety
Provide specialized education and knowledge on disease-specific conditions
Maintain current knowledge of medical and surgical procedures, products, healthcare services, drugs, healthcare delivery trends, enterprise procedures, policies, and contracts
Serve as a liaison among patients, families/caregivers, physicians, hospital discharge planners, home care providers, and ancillary providers
Work proactively with referrals to identify appropriate case management candidates, explain services, obtain voluntary agreement, and maintain a minimum patient caseload
Perform other duties as assigned

Requirements

What you’ll need

Bachelor's degree in Nursing preferred
Current active Registered Nurse (RN) license in good standing in the state(s) where job duties are performed required
Case management certification required; if not obtained before employment, URAC-recognized certification must be obtained within three years of hire
Acceptable certifications: Certified Case Manager (CCM), Accredited Case Manager (ACM), or Registered Nurse–Board Certified (RN-BC)
Minimum four years of clinical practice experience in case management, home health, critical care, medical/surgical, discharge planning, concurrent review, or obstetric/neonatal care
Ability to practice nursing within the scope of licensure and comply with policies, regulations, URAC standards, and state regulations
Ability to maintain security and confidentiality of records and information
Ability to adhere to segregation of duties guidelines
Independence and attention to detail
Skills in Administrative Process, Affinite CM, Affinite UM, CCI Edits, Collaborative Communications, Critical Reasoning, Cross-Functional Planning, Customer Relationship Management (CRM), Customer Service Workstation, Deductive Reasoning, Five9, Information Security, Interpersonal Relationship Management, Microsoft Excel, Microsoft Office, Microsoft Outlook, Microsoft PowerPoint, Needs Assessment, Oral Communications, Problem Sensitivity, Researching, Sound Judgment, Support Coordination, and Written Communication

Benefits

Comp & perks

Remote work arrangement
Regular employment
Campus travel within walking distance of the primary work assignment
Up to 40 lbs lifting and carrying allowance as part of job requirements