Arkansas Blue Cross Blue Shield

The RN Case Manager assesses, plans, and coordinates comprehensive care plans to optimize patient outcomes and ensure cost-effective healthcare delivery. They serve as a liaison between patients, families, and healthcare providers while adhering to URAC standards and state regulations.

The RN Member Triage nurse assesses members for necessary community and clinical resources while routing calls to support the Clinical Services and Population Health division. They serve as a liaison between patients, providers, and families to ensure quality of care and cost-effectiveness.

The role involves using advanced analytics to gain insights into member behavior and operational effectiveness to drive product innovation. The consultant collaborates with stakeholders to design reports and identify cost containment strategies to support strategic decision-making.