RN Case Manager

Arkansas Blue Cross and Blue Shield

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

Posted 11/11/2026full-timeRemote • United StatesMid-LevelSenior💰 $73,045 - $92,723 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in case management, patient advocacy, and compliance with healthcare regulations while providing specialized education on disease-specific conditions. Proficient in coordinating care among diverse healthcare providers and maintaining patient safety through evidence-based decision-making.

Highest-signal resume keywords

Registered Nurse (RN) LicenseCase Management CertificationClinical Practice ExperiencePatient AdvocacyCost-Effectiveness Measures

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementPatient SafetyClinical AssessmentHealthcare Delivery TrendsDischarge PlanningEvidence-Based Decision MakingDisease-Specific EducationMonitoring and EvaluationCost-Containment MeasuresCommunity Resource Coordination

Soft Skills

IndependenceDetail Oriented

Certifications & Qualifications

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

Industry Keywords

URAC StandardsState RegulationsHome HealthCritical CareMedical/SurgicalConcurrent ReviewObstetric CareNeonatal Care

About the role

Key responsibilities & impact

Assess, plan, implement, coordinate, monitor, and evaluate options and services required 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 adhere to policies, procedures, regulations, URAC standards, and state regulations.
Make decisions based on facts and evidence to ensure compliance, appropriate level of care, and patient safety.
Provide specialized education and knowledge on disease-specific conditions.
Remain current with 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 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.
Registered Nurse (RN) with current active state license in good standing in the state(s) where job duties are performed required.
Case management certification required; if not obtained prior to employment, must obtain URAC recognized certification within three (3) years of hire as a RN Case Manager.
Acceptable case management certifications: Certified Case Manager (CCM), Accredited Case Manager (ACM), and Registered Nurse - Board Certified (RN-BC).
Minimum four (4) years' clinical practice experience in case management, home health, critical care, medical/surgical, discharge planning, concurrent review, or obstetric/neonatal care.
Independence.
Detail oriented.
Must work from home within Arkansas, Washington, Oregon, Utah, Idaho, North Dakota, or Minnesota.