Transition of Care Nurse

BlueCross BlueShield of Tennessee • Chattanooga, TN

15h • Remote

About The Position

The Care Transition team at BCBST is seeking a dedicated Transition Of Care Nurse to join the team! In this role, you will play a vital part in guiding members as they move from higher to lower levels of care, ensuring discharge plans are comprehensive, appropriate, and focused on member safety and continuity of care. You will collaborate closely with hospital care coordination teams by providing remote and, when needed, on-site support to assist with discharge planning and post-acute transition needs. This position emphasizes evaluating clinical status, prior and current treatments, anticipated outcomes, and overall resource utilization to support effective care coordination and responsible cost management. In addition to the requirements for the role, strongly preferred are nurses with one of the following: a strong background in ICU, Transition of Care (TOC), Skilled Nursing Facilities (SNF), Long-Term Acute Care Hospitals (LTACH), Inpatient Rehabilitation, and Case Management. If you are passionate about improving transitions of care, influencing patient outcomes, and utilizing your clinical expertise to make a meaningful impact, we encourage you to apply. Note: RN Case Managers must be available for late shift rotation (10am-7pm EST) once a year. Also obtaining additional non-compact RN licenses as requested. At BCBST, we foster a culture where innovation is encouraged , including the responsible use of AI-enabled tools to support everyday work. As roles become more advanced, employees are expected to leverage AI, guided by established workflows, templates, and policies, to improve how we serve our members. 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
• Excellent oral and written communication skills
• PC Skills required (Basic Microsoft Office and E-Mail)
• Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis will be automatically enrolled into the BCBST Driver Safety Program.
• The employee will also be required to adhere to the guidelines set forth through the program.
• This includes, maintaining a valid driver’s license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non BCBST-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR).
• The definition for "routine basis" is defined as daily, weekly or at regularly schedule times.

Nice To Haves

• Strong background in ICU
• Transition of Care (TOC)
• Skilled Nursing Facilities (SNF)
• Long-Term Acute Care Hospitals (LTACH)
• Inpatient Rehabilitation
• Case Management

Responsibilities

• Provides telephonic or onsite services to designated hospitals as assigned/necessary to assist hospital care coordination team with discharge planning needs of the members.
• Assess resource utilization and cost management; diagnosis, past and present treatment and prognosis.
• Coordinate member needs, develop and implement treatment plans, and establish measurable goals to accomplish the goal of transitioning member to the appropriate level of care.
• Assess, implement, monitor, and evaluate available resources in an effort to promote quality, cost effective outcomes while meeting the individual's health needs.
• Must have or be able to be licensed in multiple states if required.
• Digital positions must have the ability to effectively communicate via digital channels and offer technical support; typing and grammar skills assessment is required for these positions, in addition to standard Windows 7 Testing
• Must be able to pass Windows navigation test.
• Various immunizations and/or associated medical tests may be required for this position.
• This Position requires an 18 month commitment before posting for other internal positions.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 1,001-5,000 employees