Senior Onsite Clinical Care Navigator

Blue Cross NC

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

Posted 11/4/2026full-timeFayetteville • North Carolina • United StatesSenior💰 $89,174 - $142,679 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in coordinating care and resources for member populations, conducting clinical assessments, and developing member-centric plans of care. Proficient in case management and utilization management processes, with a strong focus on addressing both physical and behavioral health needs.

Highest-signal resume keywords

RN LicensureClinical ExperienceCase ManagementUtilization ManagementCCM Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical AssessmentDischarge PlanningTreatment CoordinationClinical ReviewMember-Centric Care Planning

Soft Skills

CollaborationEngagementCommunication

Tools & Technologies

Community ResourcesFunding Sources

Certifications & Qualifications

CCM Certification

Industry Keywords

Behavioral HealthMedical NecessityContractual BenefitsInternal ResourcesExternal Resources

About the role

Key responsibilities & impact

Coordinate care, resources, and services for selected member populations
Address members’ physical and behavioral health needs
Engage members in person and telephonically at the assigned facility
Perform comprehensive clinical assessments and coordinate treatment, interventions, and discharge planning
Conduct clinical reviews based on medical necessity and contractual benefits
Collaborate with internal and external clinical and non-clinical staff, including MDs
Develop member-centric plans of care and identify barriers to achieving goals
Utilize community resources and funding sources
Refer members to internal and external resources for additional support

Requirements

What you’ll need

RN or other applicable licensure as indicated by business area
Minimum of 3 years of clinical experience
Direct experience with and knowledge of case management and utilization management functions and processes
Valid nursing license or other relevant clinical license within the US
NC or multistate/compact licensure required
Preferred: CCM Certification within 12 months of hire

Benefits

Comp & perks

Medical, dental, and vision coverage
Numerous 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
Paid Time Off (PTO)
Annual Incentive Bonus