Nurse Case Manager

We at BlueCross BlueShield of South Carolina are looking for an experienced Nurse Case Manager to join our team and provide optimal healthcare and service to our members. The ideal candidate should have a passion for helping others and a commitment to delivering the highest standard of care.The Nurse Case Manager will be responsible for providing medical direction and care management for members with complex medical needs. The successful candidate must have strong clinical knowledge, excellent communication skills, and the ability to assess, plan, and implement comprehensive care plans.Qualifications:? Licensed Registered Nurse with current South Carolina license? 5+ years of experience as a nurse, with at least two years in case management? Knowledge of medical insurance, reimbursement, and claims processes? Strong organizational, communication, and interpersonal skills? Ability to develop and maintain positive relationships with members, providers, and internal staff? Proficiency in Microsoft Office Suite and other applicationsIf you have a passion for helping others and have the qualifications we?re looking for, we would love to hear from you. Please submit your r?sum? and cover letter for consideration.

Responsibilities:

Provide medical direction and care management for members with complex medical needs.
Assess, plan, and implement comprehensive care plans.
Develop and maintain positive relationships with members, providers, and internal staff.
Monitor and evaluate members' progress and adjust plans as needed.
Communicate with other healthcare providers to ensure coordinated care.
Monitor and ensure that members receive quality services in a timely manner.
Manage and track all documentation related to members' care.
Educate members and their families on available resources and services.
Participate in team meetings and collaborate with other departments.
Stay up to date with changes in healthcare regulations and standards.

BlueCross BlueShield of South Carolina is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

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