Case Manager

Blue Cross NC

. Coordinate care, resources, and services for selected member populations .

Posted 9/15/2026full-timeRemote • North Carolina • United StatesMid-LevelSenior💰 $73,698 - $117,917 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in care coordination, comprehensive assessments, and member-centric treatment planning, while effectively utilizing healthcare resources and community support. Holds a valid RN license and possesses extensive clinical experience across various healthcare settings.

Highest-signal resume keywords

RN LicenseClinical Case ManagementComprehensive AssessmentsCare CoordinationCommunity Resource Utilization

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Treatment PlanningDischarge PlanningMonitoring and EvaluationDocumentationHealth Education

Soft Skills

CollaborationCommunicationProblem-Solving

Certifications & Qualifications

CCMCDCES

Industry Keywords

Healthcare ResourcesClinical OutcomesHigh-Risk Member OutreachMedical Necessity EvaluationInpatient Specialties

About the role

Key responsibilities & impact

Coordinate care, resources, and services for selected member populations
Provide guidance and promote effective utilization and monitoring of health care resources
Collaborate with healthcare team members to achieve optimal clinical and resource outcomes
Perform comprehensive assessments and coordinate treatment, interventions, and discharge planning
Develop member-centric plans tailored to needs, health status, education, and support requirements
Identify barriers to goals or plans of care and utilize community resources and funding sources
Monitor and manage members through follow-up, education, referrals, documentation, and plan modification
Evaluate and facilitate care across physician offices, hospitals, rehabilitation units, skilled nursing facilities, and home care
Educate members and encourage proactive intervention to limit expense and improve outcomes
Document assessment, planning, implementation, monitoring, and outcomes
Outreach to high-risk, high-cost, or high-utilization members as needed
Review alternative treatment plans, benefits, exceptions, and flex benefit options
Evaluate medical necessity and appropriateness of services
Develop policies, procedures, education, or training as needed

Requirements

What you’ll need

RN with 3 years of clinical and/or case management experience required
Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure)
Additional specialty certification (e.g. CCM, CDCES) may be required for some roles; if required, obtain it within 2 years of employment
One or more additional non-compact state nursing licenses strongly preferred
Broad clinical nursing experience across multiple care settings highly desirable, including Medical-Surgical, ICU, Emergency Department, Pediatrics, Labor & Delivery, and other inpatient specialties

Benefits

Comp & perks

Medical, dental, and vision coverage
Health and wellness programs
Parental leave and support
Adoption and surrogacy assistance
Career development programs
Tuition reimbursement for continued education
401k match including an annual company contribution
Annual Incentive Bonus
Paid Time Off (PTO)
Work-life balance, flexibility, and autonomy
Remote work with a few in-office visits each year for meaningful moments