RN Concierge Care Manager – Maternity, NICU

BlueCross BlueShield of South Carolina

RN Concierge Care Manager managing case management services for over 2 million members. Providing high-touch support for high-risk patients and coordinating healthcare services.

Posted 7/23/2026full-timeRemote • South Carolina • 🇺🇸 United StatesMid-LevelSenior💰 $57,790 - $110,388 per yearWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in case management, including the development of individualized care plans and coordination of complex healthcare services for high-risk populations. Proficient in quality improvement processes and effective communication skills to enhance member satisfaction and outcomes.

Highest-signal resume keywords

Case Management ExperienceActive RN LicensureQuality Improvement KnowledgeCustomer Service SkillsAnalytical Thinking Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Care Management ServicesIndividualized Care PlansHealthcare CoordinationRisk IdentificationTreatment Plan ImplementationQuality AssuranceContract Language KnowledgeWord Processing Software ProficiencyConfidential Information HandlingContinuing Medical Education Participation

Soft Skills

Organizational SkillsPresentation SkillsOral Communication SkillsWritten Communication SkillsNegotiation Skills

Certifications & Qualifications

Active RN LicensureCase Management Certification

Industry Keywords

High-Risk MaternityNICUESRDCancer CarePalliative CareBehavioral HealthHealth Insurance EnvironmentMember ManagementOutreach ServicesTeam Training

About the role

Key responsibilities & impact

Provide care management services to more than 2 million members in South Carolina and nationally
Administer complex, high-touch concierge case management for members identified into specialized programs such as high-risk maternity, NICU, ESRD, Cancer, Palliative Care or Behavioral Health
Identify risks and provides outreach services to facilitate the coordination of healthcare services and gap closure
Provide individualized care plans to ensure cost-effectiveness, overall care satisfaction, and improved quality of life
Directs day-to-day, high-touch member management to include implementation of program goals, coordination of treatment plans and benefit coordination for high-risk patient populations and/or those with complex conditions
Coordinates clinical services with external sources to include: providers, vendors, facilities, social workers/case managers and/or community services
Participates in team training and continuing medical education
Prepares for external audits and quality assurance efforts

Requirements

What you’ll need

Associate’s degree in nursing OR Graduate of Accredited School of Nursing OR master’s degree in social work, Psychology, or Counseling
5 years' case management experience or 2 years’ case manager experience in a health insurance environment
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
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 creative thinking skills
Ability to handle confidential or sensitive information with discretion
Active, unrestricted RN licensure from the United States and in the state of hire; OR active, compact, multistate, unrestricted RN license as defined by the Nurse Licensure Compact (NLC); OR active licensure as a social worker, psychologist, or counselor in state of hire.
Nationally recognized Case Management certification to be obtained within 2 years of hire as a Case Manager.

Benefits

Comp & perks

Subsidized health plans
Dental and vision coverage
401k 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