Medical Case Manager

BlueCross BlueShield of Tennessee • Chattanooga, TN

1d • Remote

About The Position

BlueCross BlueShield of Tennessee seeks an experienced Registered Nurse to provide compassionate, member-centered care for women navigating a wide range of women’s health needs, from pregnancy through perimenopause. This role leverages telephonic nursing and digital care delivery to educate, support, and coordinate care for members, ensuring timely, personalized, and whole-person support across the continuum of care. In this role, you will: Conduct comprehensive telephonic assessments to identify member needs and create individualized care plans Provide education, coaching, and emotional support through some of life’s most complex health transitions Deliver ongoing telephonic nursing support and care management to promote engagement and adherence Coordinate care with OB/GYNs, primary care providers, behavioral health specialists, and other partners Monitor member progress, adjust care plans as needed, and advocate for appropriate access to care You will be an ideal candidate for this role if you: Are passionate about women’s health and experienced in building trust through telephonic nursing or case management Have 3+ years of experience in women’s healthcare, maternity, GYN, women’s health, care management, or telephonic nursing Bring experience supporting members remotely through education, care coordination, and longitudinal case management Are tech-savvy, adaptable, and comfortable working in a remote, virtual care environment Demonstrate excellent communication, empathy, and problem-solving skills Value continuous program improvement and contributing to evolving care models Have excitement around (and experience leveraging) approved AI tools (e.g., Copilot) to drive efficiencies, streamline workflows, and support high‑quality outcomes

Requirements

• 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)
• This job requires digital literacy assessment.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed