Care Advocacy Case Manager RN
Remote
Job ID: R0006689
Career Area: Health Services
Date Posted: 08/10/2026
About Blue Cross and Blue Shield of Minnesota
At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.
The Impact You Will Have
Provides dedicated telephonic support to members and accounts, ensuring seamless coordination of care and resolution of complex issues. This role goes beyond traditional case management by handling appeals, scheduling appointments, and collaborating with providers, pharmacists, and internal teams to deliver exceptional service and improve member outcomes.
What You’ll Do
How You’ll Do It
At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.
Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.
Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.
The Impact You Will Have
Provides dedicated telephonic support to members and accounts, ensuring seamless coordination of care and resolution of complex issues. This role goes beyond traditional case management by handling appeals, scheduling appointments, and collaborating with providers, pharmacists, and internal teams to deliver exceptional service and improve member outcomes.
What You’ll Do
- Provides dedicated telephonic case management and care advocacy support, helping members navigate healthcare needs, resolve complex care issues, coordinate appointments, manage appeals, and connect with internal and external support programs.
- Acts as a primary point of contact for assigned accounts, collaborating with providers, pharmacists, utilization management teams, and customer service to improve member outcomes, ensure seamless care coordination, and deliver high-touch concierge-level service.
- Requires an active Minnesota RN license and significant case management experience, with responsibility for managing caseloads, documenting interventions, supporting audits, and using motivational interviewing techniques to drive member engagement and adherence to care plans.
How You’ll Do It
- Conduct telephonic outreach to members, addressing health needs and resolving issues related to care, denials, and appeals.
- Serve as a dedicated resource for assigned accounts, providing personalized support and ensuring high service standards.
- Promote and refermemberstoaccountspecific external vendors as well as internal programs such aswellness coaching, behavioralhealthand other specialty case management whereappropriate.
- Maintainaccuratedocumentation of interactions and interventions to support compliance and quality standards.
- Coordinate with providers,utilizationmanagement teams, and pharmacists tosupportappeals and resolve care-related challenges.
- Utilize motivational interviewing techniques to encourage member engagementand promote adherence tocareplans.
- Collaborate closely with account staff, and customer service tomaintainseamless communication and meet client expectations.
- Effectively manage caseloadand ensuretimelyescalation to medical directorsor pharmacistsfor high-cost or complex cases.
- Facilitate warm transfers and schedule appointments on behalf of members, delivering concierge-level service.
- Prepare for and participate in client audits to demonstrate program performance and value.
- Participate inpost-audit action plans,ask questions whereappropriateand integrate changes to improve case management practices.
- Performs additional responsibilities consistent with the scope and level of the role, as assigned.
Required Skills & Experience
- 5+ years of related case management (clinical) professional experience.
- Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.
- Registered nurse with current MN license and with no restrictions.
- CCM Certification or ability to obtain within 3 years of starting in the position.
Preferred Skills & Experience
- Ability to communicate complex topics clearly and concisely, actively listen to anticipate stakeholder needs, and align others to drive informed decisions.
- Ability to analyze complex information, evaluate options, and work cross-functionally to drive resolution and prevent recurrence.
- Ability to effectively organize work, balance competing priorities, and manage time across complex assignments and competing deadlines.
Licensure/Certifications
Required -
Registered Nurse License (RN) - MN Nursing Licensing Board
Preferred-
Certified Case Manager (CCM)
Role Designation
Remote
Teleworker
Role designation definition: Teleworking is working full time remote. Hybrid is a minimum of 2 days onsite. Onsite is full-time onsite.
Compensation and Benefits:
Pay Range: $79,100.00 - $104,800.00 - $130,500.00 Annual
Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.
We offer a comprehensive benefits package which may include:
- Medical, dental, and vision insurance
- Life insurance
- 401k
- Paid Time Off (PTO)
- Volunteer Paid Time Off (VPTO)
- And more
To discover more about what we have to offer, please review our benefits page.
Equal Employment Opportunity StatementAt Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.
Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.
Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
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