Complex Case Manager

BlueCross BlueShield of Tennessee

Registered Nurse managing complex members’ care for Tennessee’s largest health benefit plan. Coordinating interventions, referrals, utilization, and follow-up through digital and telephonic channels.

Posted 8/5/2026full-timeRemote • Tennessee • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in case management, including assessment, planning, and coordination of care for complex members with significant medical and psychosocial needs. Proficient in utilizing digital communication channels and technical support to enhance health care delivery and ensure effective interventions.

Highest-signal resume keywords

Registered Nurse (RN) License3 Years Clinical Experience5 Years Health Care Industry ExperienceDigital LiteracyCase Management

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

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

Hard Skills

Case Management ActivitiesHealth TeachingClinical JudgmentAssessment and PlanningImplementation and CoordinationMonitoring and EvaluationIntervention ImplementationUtilization ManagementTelephonic CommunicationDigital Communication

Soft Skills

Excellent Oral CommunicationExcellent Written CommunicationAttention to DetailAbility to Balance Competing PrioritiesAccountability for Results

Tools & Technologies

Microsoft OfficeEmailDigital Communication ToolsTelephonic Support

Certifications & Qualifications

Active RN License in TennesseeNurse Licensure Compact Participation

Industry Keywords

Health Care DeliveryComplex CasesIDD ExperienceMedical NeedsPsychosocial Needs

About the role

Key responsibilities & impact

Support utilization management functions for complex and non-routine cases as needed
Serve as a liaison between members, providers, and internal/external customers in coordinating health care delivery and benefits programs
Oversee highly complex cases to ensure effective implementation of interventions and efficient utilization of benefits
Perform case management activities including assessment, planning, implementation, coordination, monitoring, outcomes, and evaluation
Manage complex members telephonically and digitally with significant medical and psychosocial needs
Provide health teaching and ensure timely, effective interventions and follow-up
Apply clinical judgment to identify interventions and leverage multidisciplinary resources and referrals
Communicate effectively through digital channels and offer technical support

Requirements

What you’ll need

Registered Nurse (RN) with an active license in Tennessee, or a license in the state of residence if participating in the Nurse Licensure Compact
3 years of clinical experience required
5 years of experience in the health care industry
For Select Community, 2 years of experience in IDD is required
Excellent oral and written communication skills
Basic Microsoft Office and email skills
Strong digital literacy and technical proficiency
Ability to communicate effectively via digital and telephonic channels
Ability to manage high volumes of work while maintaining attention to detail
Ability to balance competing priorities and remain accountable for results
Must complete a digital literacy assessment
Sponsorship is not available
Certain immunizations and/or associated medical tests may be required
Employees routinely operating a company, personal, or rental vehicle must maintain a valid driver’s license, comply with auto insurance requirements, and maintain an acceptable motor vehicle record

Benefits

Comp & perks

Remote work
Remote-first organization
Working hours of Monday–Friday, 8:00 a.m.–5:00 p.m. eastern time or depending on time zone
Opportunity to leverage enterprise-approved AI tools to enhance care delivery and workflow efficiency
Relocation assistance may be available if the position requires residence in Chattanooga, TN