Care Transition Case Manager- Nashville, TN

BlueCross BlueShield of Tennessee • Nashville, TN

2d

About The Position

The Care Transition Case Manager joins the BlueCare Population Health Management Team at BCBST to support members with complex healthcare needs as they transition from hospital care to home and community-based care. The role focuses on safe, effective discharge planning, coordinated post-acute care, reducing gaps in care, and connecting members with resources to support better health outcomes. The case manager partners with members, hospital staff, physicians, specialists, and internal care teams to identify needs and address barriers.

The position requires face-to-face visits with members in Nashville-area hospitals at least one day per week, along with collaboration with facility staff on discharge planning. Candidates must live within 50 miles of Nashville, Tennessee. Sponsorship is not available. This role requires a digital literacy assessment, and various immunizations and/or associated medical tests may be required. Employees who routinely operate a company, personal, or rental vehicle for company business must participate in the BCBST Driver Safety Program and meet its requirements.

Requirements

• Active Registered Nurse (RN) license in Tennessee, or a license in the state of residence if that state participates in the Nurse Licensure Compact.
• At least 3 years of clinical experience.
• At least 5 years of experience in the healthcare industry.
• Excellent oral and written communication skills.
• Basic Microsoft Office and email skills.
• Live within 50 miles of Nashville, Tennessee.
• Complete a digital literacy assessment.
• If routinely operating a company, personal, or rental vehicle for company business, maintain a valid driver's license, meet applicable auto insurance requirements, and maintain an acceptable motor vehicle record.

Nice To Haves

• Experience in home health, community-based nursing, public health or health department settings, and/or community hospitals.
• Strong clinical judgment, critical thinking, time management, and prioritization skills.
• Self-motivation, collaboration, and a passion for improving member outcomes.
• For Select Community positions, 2 years of experience in IDD is required.

Responsibilities

• Support utilization management functions for more complex and non-routine cases as needed.
• Serve as a liaison between members, providers, and internal and external customers in coordinating healthcare delivery and benefits programs.
• Oversee highly complex cases identified through various mechanisms to ensure effective implementation of interventions and efficient utilization of benefits.
• Perform the essential activities of case management: assessment, planning, implementation, coordination, monitoring, outcomes, and evaluation.
• Conduct in-person member visits at Nashville-area hospitals at least one day per week.
• Collaborate with hospital care teams and facility staff on discharge planning.
• Coordinate services to support transitions from acute care to home and community-based care.
• Communicate effectively through digital channels and offer technical support, as applicable to digital positions.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed