Care Management Coordinator, RN
Company: Blue Cross & Blue Shield of Mississippi
Location: Flowood
Posted on: April 1, 2026
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Job Description:
Healthy Careers Start Here At Blue Cross & Blue Shield of
Mississippi, we encourage professional growth in a challenging and
fast-paced atmosphere. Our 'be healthy' culture promotes health and
wellness at all levels of the Company, and we provide our employees
with the time, tools and resources to commit to a healthy
lifestyle. The Care Management Coordinator is responsible for using
established criteria to determine if inpatient admissions,
outpatient services, home health or home infusion therapy services
are medically necessary. The Care Management Coordinator follows
cases through the review process determining medical necessity of
continuation of services and the appropriateness of the treatment
setting. The Care Management Coordinator is responsible for
identification of high-risk members and recognizing members that
may require discharge planning assistance or those that meet
criteria for referral to Case Management or Quality Management.
Job-Specific Requirements: Bachelor’s degree in Nursing and RN
licensure that is unrestricted in the state of Mississippi
required. Master's degree in Nursing preferred. Minimum two years
of clinical experience required. Background in Utilization Review
in the health care field is preferred. Excellent clinical thinking
skills required. Excellent oral/written communication skills are
required. Must have excellent organizational skills in order to
successfully prioritize tasks and to ensure deadlines and
benchmarks are consistently met. Must be able to work a flexible
schedule when required. Must have above average PC skills and
intermediate knowledge of Microsoft Office. Blue Cross & Blue
Shield of Mississippi is an Equal opportunity Employer. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability or protected veteran
status. We offer a comprehensive benefits package that is worth
approximately one-third of the salary compensation. Our benefits
program is among the best in the health care field. We are looking
for employees who can bring their experience, expertise and
dedication to work for our customers.
Keywords: Blue Cross & Blue Shield of Mississippi, Hattiesburg , Care Management Coordinator, RN, Healthcare , Flowood, Mississippi
