Capital Blue Cross

RN Care Manager – Transplant

Capital Blue Cross

full-time

Posted on:

Location Type: Remote

Location: Remote • Pennsylvania • 🇺🇸 United States

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Salary

💰 $28 - $53 per hour

Job Level

Mid-LevelSenior

About the role

  • Responsible for the coordination of services for members who meet established criteria, emphasizing education/self-management and promoting quality care and cost-effective outcomes.
  • 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.
  • Address medical, psychosocial, clinical needs, and behavioral health needs including members with mental health and substance use disorder needs.
  • 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.
  • Responsible for the management and oversight of a caseload of moderate - high risk Members with complex medical/behavioral /psychosocial needs.

Requirements

  • At least three (3) years’ recent/related experience; care management, home health, medical/surgical behavioral health, and/or critical care preferred.
  • Health plan experience preferred.
  • Additional experience related to specialized positions (Oncology, Transplant, Maternity, Behavioral Health) will also be considered.
  • Transplant experience preferred.
  • Experience in health coaching and motivational interviewing techniques 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.
  • Compact RN license preferred.
Benefits
  • Medical, Dental & Vision coverage
  • Retirement Plan
  • Generous time off including Paid Time Off, Holidays, and Volunteer time off
  • Incentive Plan
  • Tuition Reimbursement

Applicant Tracking System Keywords

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

Hard skills
care managementhealth coachingmotivational interviewingcase managementbehavioral healthmedical/surgicaltransplanthome healthclinical assessmentdischarge planning
Soft skills
collaborationcommunicationorganizationcounselingproblem-solvingmonitoringevaluationdocumentationinterpersonal skillsresource coordination
Certifications
Registered NurseCertified Case Management
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