Digital Case Manager

 Posted 2 hours ago
     
5-10 years experience
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AI Summary

Manage complex cases for members with oncology conditions and Type 1 Diabetes, ensuring effective interventions and benefit utilization. Act as a liaison between members and providers while performing full case management activities including assessment, planning, and monitoring.

BlueCross BlueShield of Tennessee (BCBST) is seeking a dedicated and experienced Nurse Case Manager to join the team!

This nurse will play a key role in managing members with newly diagnosed oncology conditions and Type 1 Diabetes, ensuring timely and effective interventions, comprehensive health education, and appropriate utilization of benefits. The ideal candidate will demonstrate strong clinical judgment to identify care needs, coordinate multidisciplinary resources and referrals, and provide consistent follow-up to support optimal outcomes.

Success in this role requires the ability to manage a high volume of cases while maintaining strong attention to detail, effectively prioritize competing demands, and remain accountable for long-term results. Strong communication skills—both digital and telephonic—along with technical proficiency and digital literacy, are essential. The ideal candidate will bring a background in oncology, acute inpatient, hospice, med surg, ICU or case management (inpatient or telephonic) experience.

Note:

·        This position requires an 18-month commitment before pursuing other internal opportunities. If you’re ready for your next career step, we encourage you to apply!

·        Although we are based in Chattanooga, TN, this is a fully remote role.

·        Sponsorship is not available for this position.

·        At BCBST, we foster a culture where innovation is encouraged, including the responsible use of AI-enabled tools to support everyday work. As roles become more advanced, employees are expected to leverage AI, guided by established workflows, templates, and policies, to improve how we serve our members.

Job Responsibilities

  • Supporting utilization management functions for more complex and non-routine cases as needed.
  • Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs.
  • Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits
  • Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation.
  • Digital positions must have the ability to effectively communicate via digital channels and offer technical support.
  • Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions. 
  • Various immunizations and/or associated medical tests may be required for this position.
  • This job requires digital literacy assessment. 

Job Qualifications

License

  • Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.

Experience

  • 3 years - Clinical experience required
  • 5 years - Experience in the health care industry
  • For Select Community & Katie Beckett: 2 years experience in IDD for Select Community is required

Skills\Certifications

  • Excellent oral and written communication skills
  • PC Skills required (Basic Microsoft Office and E-Mail)
Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis* will be automatically enrolled into the BCBST Driver Safety Program.   The employee will also be required to adhere to the guidelines set forth through the program.  This includes, maintaining a valid driver’s license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non BCBST-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR). *The definition for "routine basis" is defined as daily, weekly or at regularly schedule times.

Number of Openings Available

1

Worker Type:

Employee

Company:

BCBST BlueCross BlueShield of Tennessee, Inc.

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

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