Nurse Case Manager

At BlueCross BlueShield of South Carolina (BCBSSC), we are looking for an experienced Nurse Case Manager to join our team. We are looking for someone who is passionate about healthcare and is dedicated to helping members of our community get the care they need. The Nurse Case Manager will play an integral role in ensuring our members receive quality, cost-effective healthcare services. The ideal candidate for this role will possess a current RN license in the state of South Carolina, 3+ years of experience in medical case management, have knowledge of utilization review processes, and a thorough understanding of the healthcare system. We are seeking a self-motivated professional with excellent organizational and communication skills, and the ability to work well with multiple stakeholders. If you or someone you know is interested in this position, please submit your resume and a cover letter outlining your qualifications and experience. We look forward to hearing from you! Responsibilities: • Provide case management services to BlueCross BlueShield of South Carolina (BCBSSC) members, including conducting assessments, developing care plans, and coordinating services. • Monitor members’ medical care, ensuring cost-effective, quality services are provided. • Utilize utilization review processes to ensure efficient and appropriate utilization of healthcare services. • Maintain accurate and up-to-date documentation of members’ care plans and progress. • Communicate with members, family members, and other stakeholders, such as physicians and insurance companies, to ensure continuity of care. • Develop and implement strategies to identify and address potential health risks for members. • Utilize expertise to identify and resolve any issues related to members’ care. • Stay up-to-date on changes in the healthcare system and regulations. • Participate in team meetings and other professional development activities. 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. Apply Job!