Capital Blue Cross

RN Care Manager – Maternity

Capital Blue Cross

full-time

Posted on:

Location Type: Remote

Location: Pennsylvania • United States

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Salary

💰 $28 - $53 per hour

About the role

  • The Care Manager is responsible for the coordination of services for members who meet established criteria, with an emphasis on education/self-management and promoting quality care and cost-effective outcomes.
  • The Care Manager uses a collaborative process to assess Member needs, review options for services and resources, develop and implement a plan of care, coordinate resources, monitor progress, evaluate Member status, discharge Members, and fully document the individualized member care management process and outcome.
  • The Care Manager will address medical, psychosocial, clinical needs, and behavioral health needs including members with mental health and substance use disorder needs.
  • Care Managers provide counseling and referrals to community/local/state programs; collaborate with caregivers, providers, community agencies, behavioral health, and other resources to coordinate care to achieve member’s optimal health status.
  • The Care Manager is responsible for the management and oversight of a caseload of moderate - high risk Members with complex medical/behavioral /psychosocial needs.

Requirements

  • Registered Nurse with active licensure in home state; additional state’s licensure as needed/required to meet customer needs
  • Certified Case Management certification within 2 years of employment
  • At least three (3) years’ recent/related experience; care management, home health, medical/surgical behavioral health, and/or critical care preferred
  • Knowledge of NCQA standards for Population Health Management for health plan accreditation
  • Knowledge of evidence-based guidelines for chronic conditions/care management
  • Ability to operate a personal computer (PC), including proficiency in Microsoft Office Products.
Benefits
  • Medical, Dental & Vision coverage
  • Retirement Plan
  • Generous time off including Paid Time Off
  • Holidays
  • Volunteer time off
  • Incentive Plan
  • Tuition Reimbursement
  • More
Applicant Tracking System Keywords

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

Hard Skills & Tools
care managementcase managementchronic condition managementbehavioral health managementmedical assessmentpsychosocial assessmentdischarge planningdocumentationcounselingreferrals
Soft Skills
collaborationcommunicationorganizational skillsproblem-solvinginterpersonal skillsleadershipmonitoringevaluationeducationself-management
Certifications
Registered NurseCertified Case Management