Transition of Care Nurse

The Care Transition team at BCBST is seeking a dedicated Transition Of Care Nurse to join the team!

In this role, you will play a vital part in guiding members as they move from higher to lower levels of care, ensuring discharge plans are comprehensive, appropriate, and focused on member safety and continuity of care. You will collaborate closely with hospital care coordination teams by providing remote and, when needed, on-site support to assist with discharge planning and post-acute transition needs. This position emphasizes evaluating clinical status, prior and current treatments, anticipated outcomes, and overall resource utilization to support effective care coordination and responsible cost management.

In addition to the requirements for the role, strongly preferred are nurses with one of the following:  a strong background in ICU, Transition of Care (TOC), Skilled Nursing Facilities (SNF), Long-Term Acute Care Hospitals (LTACH), Inpatient Rehabilitation, and Case Management.

If you are passionate about improving transitions of care, influencing patient outcomes, and utilizing your clinical expertise to make a meaningful impact, we encourage you to apply.

Note:

• RN Case Managers must be available for late shift rotation (10am-7pm EST) once a year. Also obtaining additional non-compact RN licenses as requested.
• At BCBST, we foster a culture where innovation is encouraged, including the responsible use of AI-enabled tools to support everyday work. As roles become more advanced, employees are expected to leverage AI, guided by established workflows, templates, and policies, to improve how we serve our members.
• Although we are based in Chattanooga, TN, this is a fully remote role.
• Sponsorship is not available for this position.

Job Responsibilities

• Provides telephonic or onsite services to designated hospitals as assigned/necessary to assist hospital care coordination team with discharge planning needs of the members.
• Assess resource utilization and cost management; diagnosis, past and present treatment and prognosis.
• Coordinate member needs, develop and implement treatment plans, and establish measurable goals  to accomplish the goal of transitioning member to the appropriate level of care.
• Assess, implement, monitor, and evaluate available resources in an effort to promote quality, cost effective outcomes while meeting the individual’s health needs.
• Must have or be able to be licensed in multiple states if required.
• Digital positions must have the ability to effectively communicate via digital channels and offer technical support; typing and grammar skills assessment is required for these positions, in addition to standard Windows 7 Testing
• Must be able to pass Windows navigation test.
• Various immunizations and/or associated medical tests may be required for this position.
• Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions.

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

Skills\Certifications

• Excellent oral and written communication skills
• PC Skills required (Basic Microsoft Office and E-Mail)

Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis* will be automatically enrolled into the BCBST Driver Safety Program.   The employee will also be required to adhere to the guidelines set forth through the program.  This includes, maintaining a valid driver’s license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non BCBST-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR). *The definition for “routine basis” is defined as daily, weekly or at regularly schedule times.

Number of Openings Available

1 

Worker Type:

Employee 

Company:

BCBST BlueCross BlueShield of Tennessee, Inc. 

Applying for this job indicates your acknowledgement and understanding of the following statements:

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.

Further information regarding BCBST’s EEO Policies/Notices may be found by reviewing the following page:

BCBST’s EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.