RN Case Manager

Arkansas Blue Cross and Blue Shield

. Assess, plan, implement, coordinate, monitor, and evaluate comprehensive care plans and services to meet individual health needs.

Posted 11/12/2026full-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, including the assessment, planning, implementation, and evaluation of comprehensive care plans. Holds a Registered Nurse license and relevant case management certifications while ensuring compliance with healthcare regulations and standards.

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

Comprehensive Care PlanningEvidence-Based Decision MakingPatient EducationCost Containment StrategiesDischarge PlanningConcurrent ReviewMedical/Surgical ProceduresHome Health CareObstetric CareNeonatal Care

Soft Skills

IndependenceDetail Oriented

Certifications & Qualifications

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

Industry Keywords

URAC StandardsHealthcare RegulationsPatient LiaisonConfidentialitySegregation of Duties

About the role

Key responsibilities & impact

Assess, plan, implement, coordinate, monitor, and evaluate comprehensive care plans and services to meet individual health needs.
Use plan benefits and community resources to facilitate cost effectiveness and cost containment.
Practice nursing within the scope of licensure and make evidence-based decisions to ensure compliance, appropriate level of care, and patient safety.
Provide specialized education on disease-specific conditions as needed.
Remain current with medical and surgical procedures, 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.
Work from home within Arkansas, Washington, Oregon, Utah, Idaho, North Dakota, or Minnesota.
Must adhere to policies, procedures, regulations, URAC standards, and individual state regulations.
Must ensure the security and confidentiality of records and information.
Must adhere to segregation of duties guidelines.