Medical Case Manager

BlueCross BlueShield of Tennessee (BCBST) is seeking a skilled and compassionate Registered Nurse with a strong background in case management to join our fast-paced, high-performing team.  This role focuses on supporting members with acute care needs and/or chronic health conditions, ensuring they receive timely, coordinated, and effective care.

Our ideal candidate will be energized by engaging and connecting with members over the phone. They will find fulfillment in supporting our members through empathetic listening, clear communication, and proactive problem-solving.  Whether it’s guiding someone through a complex issue or simply offering a reassuring voice, our team members thrive on making meaningful connections and delivering exceptional service with every interaction.  Additionally, our ideal candidate will be adaptable, proactive, and experienced in managing complex patient needs. A background in case management and/or working with chronic conditions such as Asthma, Coronary Artery Disease (CAD), Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), and Diabetes is highly preferred.

This is an opportunity to make a meaningful impact every day by helping individuals lead healthier, more fulfilling lives through comprehensive care management.

Note: RN Case Managers must be available for occasional late shift rotation (9 am to 6 pm (Central)/ 10 am to 7 pm (Eastern).

Although we are based in Chattanooga, TN, this is a fully remote role. 

Job Responsibilities

• Supporting utilization management functions for more complex and non-routine cases as needed.
• Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs.
• Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits
• Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation.
• Digital positions must have the ability to effectively communicate via digital channels and offer technical support.
• Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions. 
• Various immunizations and/or associated medical tests may be required for this position.
• This job requires digital literacy assessment. 

Job Qualifications

License

• Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.

Experience

• 3 years - Clinical experience required
• 5 years - Experience in the health care industry
• For Select Community & Katie Beckett: 2 years experience in IDD for Select Community is required

Skills\Certifications

• Currently has a Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire.
• For Select Community & Katie Beckett: In addition to CCM, Certification in Developmental Disabilities Nursing (CDDN) is required at hire, or must be attained within 3 years.
• Excellent oral and written communication skills
• PC Skills required (Basic Microsoft Office and E-Mail)

Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis* will be automatically enrolled into the BCBST Driver Safety Program.   The employee will also be required to adhere to the guidelines set forth through the program.  This includes, maintaining a valid driver’s license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non BCBST-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR). *The definition for "routine basis" is defined as daily, weekly or at regularly schedule times.

Number of Openings Available:

1

Worker Type:

Employee

Company:

BCBST BlueCross BlueShield of Tennessee, Inc.

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.<