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Care Transition Case Manager
BlueCross BlueShield of Tennessee. Support utilization management functions for complex and non-routine cases as needed .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in case management, including assessment, planning, and coordination of healthcare delivery. Proficient in collaborating with care teams and effectively communicating with members and providers to enhance health outcomes.
Highest-signal resume keywords
Registered Nurse (RN) LicenseClinical ExperienceCase Management ActivitiesCommunication SkillsDigital Literacy
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
AssessmentPlanningImplementationCoordinationMonitoringEvaluationUtilization ManagementDischarge PlanningPost-Acute Services CoordinationHealth Outcomes Improvement
Soft Skills
Oral CommunicationWritten CommunicationInterpersonal SkillsProblem-Solving
Tools & Technologies
Microsoft OfficeEmail
Certifications & Qualifications
Active RN License in Tennessee
Industry Keywords
Healthcare DeliveryComplex CasesTransitions of CareIDD ExperienceNurse Licensure Compact Law
About the role
Key responsibilities & impact- Support utilization management functions for complex and non-routine cases as needed
- Serve as a liaison between members, providers, and internal/external customers in coordinating healthcare delivery and benefits programs
- Oversee highly complex cases to ensure effective interventions and efficient utilization of benefits
- Perform case management activities including assessment, planning, implementation, coordination, monitoring, outcomes, and evaluation
- Conduct face-to-face member visits in Nashville-area hospitals
- Collaborate with hospital care teams on discharge planning
- Coordinate post-acute services and resources for transitions from acute care to home and community-based care
- Identify member needs, remove barriers to care, and support improved health outcomes
Requirements
What you’ll need- Registered Nurse (RN) with active license in the state of Tennessee or a license in the state of residence if participating in the Nurse Licensure Compact Law
- 3 years of clinical experience required
- 5 years of experience in the health care industry
- For Select Community & Katie Beckett: 2 years of experience in IDD for Select Community is required
- Excellent oral and written communication skills
- Basic Microsoft Office and email skills
- Ability to travel to Nashville-area hospitals at least one day per week
- Must live within 50 miles of Nashville, TN
- Sponsorship is not available for this role
- Ability to communicate effectively via digital channels and offer technical support
- Digital literacy assessment required
- Employees routinely operating a company, personal, or rental vehicle must maintain a valid driver's license, comply with auto insurance requirements, and maintain an acceptable motor vehicle record
Benefits
Comp & perks- Full-time employee position
- Various immunizations and/or associated medical tests may be required for this position