Care Transition Case Manager- Knoxville Area

BlueCross BlueShield of Tennessee • Knoxville, TN

91d

About The Position

Are you driven by compassion and the desire to support others as they transition smoothly from hospital care to the comfort of their own home? Join us in empowering at-risk individuals to navigate the healthcare system and access the resources they need to meet their complex needs. As a Care Transition Case Manager, you will play a vital role in ensuring safe and effective discharge planning by partnering with the member, our internal team, facility staff, including nurses, case managers, discharge planners and social workers. You will also be working with the members, primary care providers and specialist to coordinate care post discharge. In this role, you will be onsite at Knoxville Area Hospitals at least once a week to conduct face-to-face meetings with our members to discuss their discharge needs. You will coordinate care directly with hospital staff. Your efforts will help bridge the gap between acute care and home, supporting members through a smooth and informed transition. We’re looking for individuals with strong critical thinking skills, excellent time management, and the ability to prioritize task efficiently. If you’re self-motivated and thrive in a fast-paced environment, we’d love to have you on our team.

Requirements

• 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.
• 3 years of clinical experience required.
• 5 years of experience in the health care industry.
• For Select Community & Katie Beckett: 2 years experience in IDD for Select Community is required.
• Currently has a Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire.
• For Select Community & Katie Beckett: 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).

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.
• Communicating effectively via digital channels and offering technical support.

What This Job Offers

• Number of Employees: 5,001-10,000 employees