Women's Healthcare Case Manager (Remote)

BlueCross BlueShield of Tennessee • Chattanooga, TN

16d • Remote

About The Position

BlueCross BlueShield of Tennessee seeks an experienced RN to provide compassionate, member-centered care for women navigating women’s health conditions; from pregnancy to perimenopausal related. This role involves telephonic and digital outreach, education, and care coordination with providers to ensure timely, personalized support. In this role, you will: Assess member needs and create individualized care plans. Educate and support members through some of life’s most complex transitions. Coordinate care with OB/GYNs, PCPs, and behavioral health specialists Monitor progress, adjust plans, and advocate for access and adherence You will be an ideal candidate for this role, if, in addition to the required qualifications, you: Are passionate about women’s health, skilled at building trust, and motivated to empower members through complex health transitions. Have 3+ years of experience in women's healthcare (maternity, GYN, women’s health) Are tech-savvy, adaptable, and comfortable in a remote setting Have excellent communication, empathy, and problem-solving skills Appreciate continuous program improvement

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
• Currently has a Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire.
• For Select Community & Katie Beckett: In addition to CCM, Certification in Developmental Disabilities Nursing (CDDN) is required at hire, or must be attained within 3 years.
• Excellent oral and written communication skills
• PC Skills required (Basic Microsoft Office and E-Mail)
• This job requires digital literacy assessment.

Nice To Haves

• Are passionate about women’s health, skilled at building trust, and motivated to empower members through complex health transitions.
• Have 3+ years of experience in women's healthcare (maternity, GYN, women’s health)
• Are tech-savvy, adaptable, and comfortable in a remote setting
• Have excellent communication, empathy, and problem-solving skills
• Appreciate continuous program improvement

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees