Registered Nurse, Case Manager (BCBS) - Quality Management (Main Clinic)

POSITION SUMMARY: The Blue Cross Blue Shield Case Management Nurse utilizes a collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet the Blue Cross Blue Shield patients’ health needs through communication and targeted intervention to promote optimal, cost-effective outcomes in a clinic setting.  The function of this position is to assist Blue Cross Blue Shield patients in the administration of their health plan benefits.  The Blue Cross Blue Shield Case Management Nurse focuses on arranging or coordination services that the patient needs to get well or stay well and removing barriers that prevent the member from engaging in an appropriate plan of care.  The Blue Cross Blue Shield Case Management Nurse demonstrates the strengths working independently as well as collaboratively within a multi-specialty healthcare environment.  

QUALIFICATIONS: Graduate of accredited school of nursing required-Registered Nurse, with current state licensure required. Prefer at least three years of experience. Knowledge of EMR, medical management and policies and procedures. Intermediate skills in work processing, spreadsheet and database development and maintenance. Excellent organizational, written, and oral communication skills.

WORK SCHEDULE:  Monday - Friday 8:00AM - 5:00PM