Case Manager

Blue Cross NC

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

Posted 9/23/2026full-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 planning while effectively utilizing healthcare resources and community services. Holds a valid RN license and possesses extensive clinical nursing experience across various care settings.

Highest-signal resume keywords

RN LicenseClinical Case Management ExperienceCare CoordinationComprehensive AssessmentsMember-Centric Care Planning

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care CoordinationComprehensive AssessmentsTreatment PlanningDocumentationMonitoring OutcomesEducation and TrainingResource UtilizationDischarge PlanningEvaluation of Medical NecessityFollow-Up Management

Soft Skills

CollaborationCommunicationProactive InterventionProblem SolvingMember Education

Certifications & Qualifications

CCMCDCES

Industry Keywords

Healthcare ResourcesClinical OutcomesHigh-Risk Member OutreachSkilled Nursing FacilitiesRehabilitation Units

About the role

Key responsibilities & impact

Coordinate care, resources, and/or 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 of care and identify barriers to goals
Utilize community resources and funding sources
Monitor and manage members through follow-up, education, referrals, documentation, and plan modifications
Evaluate and facilitate care across the continuum, including physician offices, hospitals, rehabilitation units, skilled nursing facilities, and home care
Educate members and encourage proactive intervention
Document assessments, plans, implementation, monitoring, and outcomes
Potentially outreach to high-risk, high-cost, or high-utilization members
Potentially review alternative treatment plans, benefits exceptions, and flex benefit options
Potentially evaluate medical necessity and service appropriateness
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)
For some roles, additional specialty certification (i.e. CCM, CDCES) may be required; relevant certification must be obtained within 2 years of employment if applicable
At this time, Blue Cross NC will not sponsor employment authorization for this position
Holding one or more additional non-compact state nursing licenses is strongly preferred
Broad clinical nursing experience across multiple care settings is highly desirable

Benefits

Comp & perks

Work-life balance, flexibility, and autonomy
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)