Care Transition Case Manager- Nashville, TN
About The Position
The Care Transition Case Manager works on the BlueCare Population Health Management Team, supporting members with complex healthcare needs as they transition from hospital care to home and community settings. The role focuses on safe and effective discharge planning, coordinated post-acute care, identifying member needs, removing barriers, and connecting members with resources to support better health outcomes. The position involves face-to-face visits with members in Nashville-area hospitals and collaboration with hospital care teams, members, physicians, specialists, and internal care teams. The employee will coordinate services that support a smooth transition from acute care and contribute to reducing gaps in care. Travel to Nashville-area hospitals is required at least one day per week, and candidates must live within 50 miles of Nashville, Tennessee. Sponsorship is not available. The position requires a digital literacy assessment; various immunizations and/or associated medical tests may also be required. Employees who routinely operate a company, personal, or rental vehicle for company business are enrolled in the BCBST Driver Safety Program and must meet its driving and insurance requirements.
Requirements
- Active Registered Nurse (RN) license in Tennessee, or a license in the employee’s state of residence if that state participates in the Nurse Licensure Compact.
- Three years of clinical experience.
- Five years of experience in the healthcare industry.
- Excellent oral and written communication skills.
- Basic PC skills, including Microsoft Office and email.
- Ability to travel to Nashville-area hospitals at least one day per week; candidates must live within 50 miles of Nashville, Tennessee.
- For Select Community and Katie Beckett: two years of experience in IDD is required for Select Community.
- 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.
- Complete a digital literacy assessment.
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.
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, including assessment, planning, implementation, coordination, monitoring, outcomes, and evaluation.
- Conduct in-person member visits at Nashville-area hospitals and collaborate with facility staff on discharge planning.
- Coordinate services and connect members with resources to facilitate transitions from acute care to home and community-based care.
- Communicate effectively through digital channels and offer technical support, as applicable to digital positions.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
