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Nurse Care Manager – Katie Beckett
BlueCross BlueShield of Tennessee. Manage a caseload of multiple complex pediatric member needs .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in pediatric case management, including assessment, planning, and coordination of care for medically fragile children. Proficient in developing Person Centered Support Plans and collaborating with insurance providers to ensure comprehensive coverage.
Highest-signal resume keywords
Pediatric ExperienceActive Registered Nurse (RN) LicenseClinical Expertise in Medically Fragile Children3 Years of Clinical Experience5 Years of Experience in Health Care
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Case Management ActivitiesAssessment and PlanningPerson Centered Support PlansChild Development AssessmentUtilization ManagementCoordination of CareMonitoring and EvaluationDigital LiteracyHome and Community-Based ServicesBehavioral Health Coordination
Soft Skills
Strong Communication SkillsOrganizational SkillsAttention to DetailFlexibility and AdaptabilityEffective Communication
Tools & Technologies
Microsoft OfficeEmail Communication
Certifications & Qualifications
Active Registered Nurse (RN) License in TennesseeNurse Licensure Compact Eligibility
Industry Keywords
Pediatric CareMedicaidPrivate InsuranceIDD ExperienceHealth Care Industry
About the role
Key responsibilities & impact- Manage a caseload of multiple complex pediatric member needs
- Conduct member visits, including home visits, within contract timelines
- Perform new member visits and ongoing assessments
- Develop and maintain Person Centered Support Plans
- Collaborate with private insurance and Medicaid to coordinate care and ensure appropriate coverage
- Support utilization management functions for complex and non-routine cases
- Serve as a liaison between members, providers, and internal/external customers
- Oversee highly complex cases and implement interventions for efficient benefits utilization
- Perform case management activities including assessment, planning, implementation, coordination, monitoring, outcomes, and evaluation
- Provide effective communication via digital channels and technical support
- Assess child development and milestones and provide resources for identified deficiencies
- Identify goals and challenges through person- and family-centered planning
- Identify needed home and community-based services
- Coordinate additional Medicaid medical and behavioral health benefits
Requirements
What you’ll need- Pediatric experience
- Strong communication and organizational skills
- Attention to detail
- Flexibility and adaptability
- Willingness to travel for face-to-face meetings with members
- Active Registered Nurse (RN) license in Tennessee, or a license in the state of residence if participating in the Nurse Licensure Compact
- 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 required
- Excellent oral and written communication skills
- Basic Microsoft Office and email skills
- Pediatric experience, preferably from an acute care setting
- Clinical expertise caring for medically fragile children with complex medical and/or behavioral health needs
- Ability to assess child development and milestones
- Valid driver's license, compliant auto insurance, and acceptable motor vehicle record if routinely operating a vehicle for company business
- Ability to complete a digital literacy assessment
- 18-month commitment before posting for other internal positions
Benefits
Comp & perks- Employee position
- Various immunizations and/or associated medical tests may be required for this position