Managed Care Coordinator II – Oncology Focus

BlueCross BlueShield of South Carolina

Care Manager focusing on care coordination for oncology patients at BlueCross BlueShield. Evaluating outcomes and advocating for members with chronic conditions remotely.

Posted 7/21/2026full-timeRemote • South Carolina • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in care management, including assessment of service needs, development of action plans, and evaluation of outcomes. Proficient in communication, documentation, and adherence to medical necessity and benefit guidelines.

Highest-signal resume keywords

Care ManagementClinical DocumentationCustomer ServiceAnalytical SkillsCommunication Skills

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Clinical AssessmentQuality Improvement ProcessesContract Language KnowledgeData CollectionBenefit Eligibility Evaluation

Soft Skills

Good JudgmentOrganizational SkillsPresentation SkillsNegotiation SkillsAbility to Work Independently

Tools & Technologies

Word Processing Software

Certifications & Qualifications

Associate's Degree in Related Field

Industry Keywords

Medical NecessityChronic ConditionsHigh-Risk PregnancyPatient EducationClaims Adjudication

About the role

Key responsibilities & impact

Provides active care management, assesses service needs, develops and coordinates action plans in cooperation with members, monitors services and implements plans, to include member goals
Evaluates outcomes of plans, eligibility, level of benefits, place of service, length of stay, and medical necessity regarding requested services and benefit exceptions
Ensures accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits
Provides telephonic support for members with chronic conditions, high-risk pregnancy or other at-risk conditions
Participates in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks and benefit plans
Serves as member advocate through continued communication and education
Provides appropriate communications (written, telephone) regarding requested services to both health care providers and members
Ensures coverage for appropriate services within benefit and medical necessity guidelines
Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.)
Participates in data collection/input into system for clinical information flow and proper claims adjudication

Requirements

What you’ll need

Associate's in a job related field
4 years recent clinical in defined specialty area
Working knowledge of word processing software
Knowledge of quality improvement processes and demonstrated ability with these activities
Knowledge of contract language and application
Ability to work independently, prioritize effectively, and make sound decisions
Good judgment skills
Demonstrated customer service, organizational, and presentation skills
Demonstrated proficiency in spelling, punctuation, and grammar skills
Demonstrated oral and written communication skills
Ability to persuade, negotiate, or influence others
Analytical or critical thinking skills
Ability to handle confidential or sensitive information with discretion

Benefits

Comp & perks

Subsidized health plans
Dental and vision coverage
401 k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more