Case Manager

2 weeks ago


Knoxville, Tennessee, United States BlueCross BlueShield of Tennessee Full time
Job Summary

We are seeking a highly skilled Case Manager to join our team at BlueCross BlueShield of Tennessee. As a Case Manager, you will play a critical role in supporting the utilization management functions for complex and non-routine cases, serving as a liaison between members, providers, and internal/external customers, and overseeing highly complex cases to ensure effective implementation of interventions and efficient utilization of benefits.

Key Responsibilities
  • Assess patient needs and develop individualized care plans
  • Coordinate with healthcare providers to ensure seamless care delivery
  • Monitor patient outcomes and adjust care plans as needed
  • Communicate effectively with patients, families, and healthcare teams
  • Ensure compliance with regulatory requirements and company policies
Requirements
  • Registered Nurse (RN) with active license in the state of Tennessee or participating states
  • 3 years of clinical experience required; 5 years of experience in the healthcare industry preferred
  • Currently certified as a Certified Case Manager (CCM) or must obtain certification within 2 years of hire
  • Excellent communication and interpersonal skills
  • Ability to work in a fast-paced environment and prioritize multiple tasks
What We Offer
  • A competitive salary and benefits package
  • Opportunities for professional growth and development
  • A dynamic and supportive work environment
  • Relocation assistance for candidates who need to move to Tennessee

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