Care Transition Case Manager- Memphis, TN

BlueCross BlueShield of Tennessee • Memphis, TN

3d

About The Position

BlueCross BlueShield of Tennessee is hiring a Care Transition Case Manager for the BlueCare Population Health Management Team. The role supports members with complex healthcare needs as they transition from hospital care to their homes and communities. The Case Manager conducts face-to-face member visits in area hospitals, partners with hospital staff and care teams on discharge planning, and coordinates post-acute services to support safe, effective transitions and improved health outcomes. The position requires travel to Memphis-area hospitals at least one day per week for in-person visits and collaboration with facility staff. Candidates must live within 50 miles of Memphis, Tennessee. Sponsorship is not available. The position requires an 18-month commitment before applying for other internal positions. Various immunizations and/or associated medical tests may be required, and a digital literacy assessment is required.

Requirements

• Active Registered Nurse (RN) license in Tennessee, or a license in the candidate’s state of residence if that state participates in the Nurse Licensure Compact.
• 3 years of clinical experience.
• 5 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 Memphis-area hospitals at least one day per week and live within 50 miles of Memphis, Tennessee.
• For Select Community & Katie Beckett: 2 years of experience in IDD for Select Community is required.

Nice To Haves

• Experience with behavioral health and/or home health care is preferred.
• Experience in home health, community-based nursing, public health or health department settings, and/or community hospitals is identified as ideal.

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 essential case management activities, including assessment, planning, implementation, coordination, monitoring, outcomes, and evaluation.
• Conduct in-person member visits at Memphis-area hospitals and collaborate with facility staff on discharge planning.
• Coordinate post-acute services and connect members with resources to support transitions from acute care to home and community-based care.
• Communicate effectively through digital channels and offer technical support, as required for digital positions.

What This Job Offers

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