RN Care Manager

Capital Blue Cross

Care Manager at Capital Blue Cross coordinating services for healthcare members. Focus on assessing needs, implementing care plans, and collaborating with providers for optimal health outcomes.

Posted 5/8/2026full-timeRemote • Pennsylvania • 🇺🇸 United StatesMid-LevelSenior💰 $28 - $53 per yearWebsite

About the role

Key responsibilities & impact

Responsible for the coordination of services for members who meet established criteria
Uses a collaborative process to assess Member needs, review options for services and resources, develop and implement a plan of care
Monitor progress, evaluate Member status, discharge Members, and fully document the individualized member care management process and outcome
Provide counseling and referrals to community/local/state programs; collaborate with caregivers, providers, community agencies, behavioral health, and other resources to coordinate care

Requirements

What you’ll need

At least three (3) years’ recent/related experience in care management, home health, medical/surgical behavioral health, and/or critical care preferred
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
Knowledge of NCQA standards for Population Health Management for health plan accreditation
Knowledge of clinical and managed care principles and operations

Benefits

Comp & perks

Medical, Dental & Vision coverage
Retirement Plan
Generous time off including Paid Time Off, Holidays, and Volunteer time off
Incentive Plan
Tuition Reimbursement

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

care managementhome healthmedical/surgical behavioral healthcritical careclinical principlesmanaged care principlespopulation health management

Soft Skills

collaborationcounselingevaluationdocumentation

Certifications

Registered NurseCertified Case Management