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 11/10/2026full-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 assessment, planning, and implementation of healthcare services while ensuring compliance with regulations and patient safety. Holds a Registered Nurse license and relevant case management certifications to effectively coordinate care and educate patients on disease-specific conditions.

Highest-signal resume keywords

Registered Nurse (RN) LicenseCase Management CertificationClinical Practice ExperienceEvidence-Based Decision MakingPatient Safety Compliance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementPatient AssessmentCare CoordinationHealthcare Delivery TrendsCost Containment MeasuresDischarge PlanningMedical/Surgical KnowledgeDisease-Specific EducationConcurrent ReviewHome Health Experience

Soft Skills

IndependenceDetail Oriented

Certifications & Qualifications

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

Industry Keywords

URAC StandardsState RegulationsHealthcare ServicesPatient LiaisonConfidentiality Requirements

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 comply with policies, procedures, regulations, URAC standards, and state regulations.
Make evidence-based decisions to ensure compliance, appropriate level of care, and patient safety.
Provide specialized education and knowledge on disease-specific conditions.
Stay 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 security and confidentiality requirements and segregation of duties guidelines.