RN Case Manager (Nashville)

This is a remote, Monday–Friday (8:00 a.m.–5:00 p.m.) role with flexibility to support member needs. Candidates must live within 50 miles of Nashville, TN and be available for monthly home visits in the Nashville area. Sponsorship is not available for this role.

About the role

Support TennCare (Medicaid) members with complex medical, functional, and social needs by coordinating home and community-based care, conducting required home visits, and assisting members transitioning to adult benefits. Collaborate closely with providers and internal care teams using digital tools to identify care gaps, reduce hospitalization risk, and improve outcomes.

Responsibilities

• Support utilization management functions for complex and non-routine cases as needed.
• Serve as a liaison between members, providers, and internal/external customers to coordinate healthcare delivery and benefits programs.
• Oversee highly complex cases to ensure effective implementation of interventions and efficient utilization of benefits.
• Perform essential case management activities: assessment, planning, implementation, coordination, monitoring, outcomes, and evaluation.
• Communicate effectively via digital channels and provide technical support.

This position requires an 18-month commitment before posting for other internal positions. Various immunizations and/or associated medical tests may be required. A digital literacy assessment is part of the job requirements.

Requirements

• Active Registered Nurse (RN) license in the state of Tennessee or a participating Nurse Licensure Compact state.
• 3 years of clinical experience.
• 5 years of experience in the healthcare industry.
• For Select Community & Katie Beckett: 2 years of experience in Intellectual and Developmental Disabilities (IDD).
• Excellent oral and written communication skills.
• Proficiency in basic Microsoft Office and email.

Employees required to operate a vehicle for company business on a routine basis must adhere to BCBST’s Driver Safety Program, including maintaining a valid driver’s license, auto insurance, and an acceptable motor vehicle record (MVR).

Preferred Qualifications

• Home health or hospice nursing experience.
• Pediatric experience.
• Knowledge of Medicaid Long-Term Services and Supports (MTLSS) programs.
• Familiarity with community-based services.

Schedule

• Monday–Friday, 8:00 a.m.–5:00 p.m.