Nurse Case Manager

The Complex Care Team at BCBST is seeking a compassionate and highly skilled RN Case Manager to support members with advanced and multifaceted healthcare needs.

In this role, you will provide comprehensive, member-centered care for individuals with complex and chronic conditions, including high-risk diagnoses, through a proactive, advocacy-driven approach. You will collaborate across multidisciplinary teams to coordinate care, reduce barriers, and improve health outcomes while supporting cost-effective utilization of services.

Success in this position requires the ability to manage a dynamic caseload with strong critical thinking, attention to detail, and exceptional telephonic and digital communication skills. Ideal candidates will bring demonstrated experience in case management or acute care settings such as ICU, Med-Surg, Oncology, or Home Health, along with strong technical proficiency and a willingness to leverage enterprise-approved digital and AI tools to enhance care delivery and operational efficiency.

Note:

• Although we are based in Chattanooga, TN, this is a fully remote role.
• Sponsorship is not available for this position.

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)

Additional Information

• Number of Openings Available: 1
• Worker Type: Employee
• Company: VSHP Volunteer State Health Plan, Inc

Equal Opportunity Employer

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.

About BCBST

As Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health since 1945. We foster a culture where innovation is encouraged, including using AI-enabled tools responsibly to support everyday work.

BCBST is a remote-first organization. We hire employees for remote positions from across the U.S. with the exception of the following states: California, Massachusetts, New Hampshire, New Jersey, and New York. Applicants living in these states may move to an approved state prior to starting a position with BCBST at their own expense.