RN Behavioral Health Concierge Care Manager

BlueCross BlueShield of South Carolina

RN Behavioral Health Concierge Care Manager providing high-touch case management for BlueCross South Carolina members. Coordinating specialized healthcare programs, care plans, authorizations, and quality outcomes remotely.

Posted 8/17/2026full-timeRemote • South Carolina • 🇺🇸 United StatesJuniorMid-Level💰 $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. Holds active RN licensure or relevant social work credentials, with a strong focus on quality improvement and effective communication.

Highest-signal resume keywords

Case Management ExperienceActive RN LicensureNationally Recognized Case Management CertificationMicrosoft Office ProficiencyQuality Improvement Knowledge

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

Care Management ServicesIndividualized Care PlansComplex Condition CoordinationPrior Authorization GuidanceRisk IdentificationHealthcare OutreachAnalytical ThinkingContract Language KnowledgeQuality Assurance PreparationPresentation Skills

Soft Skills

Customer Service SkillsOrganizational SkillsOral Communication SkillsWritten Communication SkillsNegotiation Skills

Tools & Technologies

Word Processing SoftwareMessaging SystemHigh-Speed InternetSecure Home Office

Certifications & Qualifications

Active RN LicensureCase Manager CertificationBasic Life Support (BLS)Advanced Cardiac Life Support (ACLS)

Industry Keywords

High-Risk MaternityNICUESRDCancer CarePalliative CareBehavioral HealthAutism SpecialtyHome HealthHospiceICU

About the role

Key responsibilities & impact

Provide care management services to members in South Carolina and nationally
Administer complex, high-touch concierge case management for specialized programs including high-risk maternity, NICU, ESRD, cancer, palliative care, and behavioral health
Identify risks and conduct outreach to coordinate healthcare services and close care gaps
Create individualized care plans focused on cost-effectiveness, care satisfaction, and quality of life
Direct day-to-day high-touch member management and implement program goals
Coordinate treatment plans and benefits for high-risk and complex-condition populations
Coordinate clinical services with providers, vendors, facilities, social workers/case managers, and community services
Educate and guide members through prior authorizations, medication adherence, and care plans
Conduct most interactions by phone and messaging system
Participate in team training and continuing medical education
Prepare for external audits and quality assurance efforts

Requirements

What you’ll need

Associate’s degree in nursing OR graduate of an 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, presentation, spelling, punctuation, grammar, oral communication, 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
Proficiency with Microsoft Office
Active, unrestricted RN licensure from the United States and in the state of hire; OR active compact, multistate, unrestricted RN license under the Nurse Licensure Compact; OR active licensure as a social worker, psychologist, or counselor in the state of hire
Nationally recognized Case Management certification to be obtained within 2 years of hire as a Case Manager
Preferred bachelor’s degree in a health-related field
Preferred experience in an Autism specialty or working with autistic patients
Preferred 5 years’ case management experience in a sub-specialty area such as ICU, Palliative Care, Hospice, or Home Health
Preferred case manager certification or clinical certification in a specialty area
Preferred Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS) certification
High-speed, non-satellite internet
Private, secure home office
Availability Monday-Friday, 8:00am-5:00pm EST
Current RN license copy or RN license number on resume requested

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
Diverse and inclusive workplace
Opportunities to develop skills and advance careers
Reasonable accommodations for disabilities, pregnancy-related conditions, and sincerely held religious beliefs