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Manager overseeing medical review processes for Medicare claims at BlueCross BlueShield of South Carolina. Ensuring compliance with standards and laws while driving continuous improvement in claim processing.
About the role
- RN Care Manager coordinating care for members with disabilities through home visits and assessments. Working within an interdisciplinary team while working from home or flexible arrangements.
Responsibilities
- Join an interdisciplinary team serving members with physical disabilities and intellectual/developmental disabilities.
- Coordinate and participate in home visits and care conferences.
- Conduct comprehensive assessments and develop member-centered plans.
- Implement risk mitigation strategies and maintain member records.
Requirements
- Current License to practice as a Registered Nurse in the State of Wisconsin.
- Bachelor’s degree in nursing strongly preferred.
- Two (2) or more years of skilled nursing experience preferred, ideally in gerontology/disabilities and/or home care.
- Ability to access members’ homes which are not required to comply with the ADA regulations.
- Ability to lift up to 25lbs.
- Current driver’s license, acceptable driving record and proof of adequate insurance.
Benefits
- Flexible work arrangements
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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