Nurse Case Manager

BlueCross BlueShield of TennesseeChattanooga, TN
Remote

About The Position

The Complex Care Team at BCBST is seeking a compassionate and highly skilled RN Case Manager to support members with advanced and multifaceted healthcare needs. In this role, you will provide comprehensive, member-centered care for individuals with complex and chronic conditions, including high-risk diagnoses, through a proactive, advocacy-driven approach. You will collaborate across multidisciplinary teams to coordinate care, reduce barriers, and improve health outcomes while supporting cost-effective utilization of services. Success in this position requires the ability to manage a dynamic caseload with strong critical thinking, attention to detail, and exceptional telephonic and digital communication skills. Ideal candidates will bring demonstrated experience in case management or acute care settings such as ICU, Med-Surg, Oncology, or Home Health, along with strong technical proficiency and a willingness to leverage enterprise-approved digital and AI tools to enhance care delivery and operational efficiency. Note: Although we are based in Chattanooga, TN, this is a fully remote role. Sponsorship is not available for this position.

Requirements

  • 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.
  • 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
  • Excellent oral and written communication skills
  • PC Skills required (Basic Microsoft Office and E-Mail)

Nice To Haves

  • Experience in case management or acute care settings such as ICU, Med-Surg, Oncology, or Home Health
  • Strong technical proficiency
  • Willingness to leverage enterprise-approved digital and AI tools to enhance care delivery and operational efficiency.

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.
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