RN Case Management Supervisor

BlueCross BlueShield of South Carolina

Case Management Supervisor overseeing utilization review, care management, quality, and specialty healthcare programs. Supervising staff, compliance, reporting, and outcomes for BlueCross BlueShield of South Carolina.

Posted 8/21/2026full-timeSouth Carolina • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in Utilization Review, Case Management, and Quality Management, with a strong focus on staff supervision, training, and performance evaluation. Proficient in data analysis, compliance activities, and developing wellness programs to enhance health management outcomes.

Highest-signal resume keywords

Utilization ReviewCase ManagementQuality Improvement ProcessActive RN LicensureLeadership Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisQuality ControlWorkflow VerificationAudit Procedures DevelopmentHealth PromotionHealth EducationManaged Care KnowledgeInsurance Programs UnderstandingProgram DevelopmentPerformance Review

Soft Skills

Excellent Communication SkillsOrganizational SkillsCustomer Service SkillsCritical ThinkingDecision-Making

Tools & Technologies

Microsoft Office

Certifications & Qualifications

Case Management CertificationActive Unrestricted RN LicensureLMSW LicensureLISW LicensureLPC Licensure

Industry Keywords

Health ManagementHealthcare Delivery SystemsURAC ComplianceNCQA ComplianceWellness Programs

About the role

Key responsibilities & impact

Supervise and maintain daily functions across Utilization Review/Review Nurses, Case Management, Medical Review, Health/Disease Management, Quality Management, and/or appeals
Supervise day-to-day activities for assigned staff
Identify staff training needs
Verify workflow accuracy, efficiency, and effectiveness
Develop and oversee specialty programs, including wellness, preventive, and/or employer work site programs
Approve staff time and leave and conduct performance reviews
Select, train, and motivate staff to provide excellent customer service
Develop, maintain, and update audit procedures and documentation
Develop and communicate department standards and staff expectations
Perform quality control and develop work plans to improve quality performance
Analyze program components and collect data for outcomes reporting
Prepare, review, and maintain weekly/monthly management reports
Oversee data collection and URAC/NCQA compliance activities
Coordinate with corporate departments to ensure effective communication

Requirements

What you’ll need

Associate's in a job-related field
Graduate of Accredited School of Nursing as a degree equivalency
5 years of combined health promotion, health education, health insurance, clinical, medical, pharmacy, or other healthcare experience
If Master’s Degree, 3 years of required experience
One year experience in a team lead/leadership role or equivalent military experience in grade E4 or above (may be concurrent)
Understanding of insurance and benefit programs as they relate to health management coverage
Working knowledge of managed care and/or various forms of health care delivery systems
Knowledge of specific criteria/protocol sets and their use
Knowledge/understanding of the quality improvement process
Ability to work independently, prioritize effectively, and make sound decisions
Excellent communication skills
Ability to work with a wide variety of internal and external customers
Good judgment skills
Demonstrated customer service, organizational, and presentation skills
Demonstrated verbal and written communication skills
Analytical, critical thinking, and math skills for collecting, analyzing, and reporting data
Ability to persuade, negotiate, or influence others
Ability to handle confidential or sensitive information with discretion
Ability to direct, motivate, and assess performance of others
Microsoft Office proficiency
Active, unrestricted RN licensure from the United States and the state of hire, or active compact multistate unrestricted RN license under the Nurse Licensure Compact; alternatively, active unrestricted professional healthcare licensure/certification in the specialty, active unrestricted LMSW, LISW, or LPC licensure, or a Master's in Public Health/Healthcare Administration with three additional years of health-related experience
Must obtain Case Management certification from a URAC accrediting body within 3 years of hire for non-Medicaid roles
Preferred: at least 3 years of leadership experience at supervisor level or above in Care Management

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
Reasonable accommodations for individuals with disabilities, pregnant individuals, pregnancy-related conditions, and sincerely held religious beliefs