Job Description We're seeking a Senior Episodic Care Manager to join our Behavioral Health Team! The Senior Episodic Care Manager - Behavioral Health Autism Services utilizes advanced knowledge and experience in utilization management and medical reviews to perform varied senior-level functions for the department. Drives operational efficiencies, works with internal and external partners for care coordination, and provides input to valuable Utilization Management (UM) initiatives that support the delivery of high quality and cost-effective care across the health care system. What You'll Do - Support member care coordination and departmental goals by performing Perform clinical evaluation and review of various member services for prior authorization or transition of care needs as needed to meet departmental goals - Act as a subject matter expert to support clinical UM staff as first point of contact with process, business, and/or clinical questions. - Serve as point of contact for internal stakeholders to provide expertise on utilization management related to discharge planning, the review of sales documents and benefit booklets, and/or other project/initiative support. - Apply significant expertise in discharge planning and utilization management to expedite the coordination of services and equipment and facilitate safe and effective discharge plans for our members. - Provide precepting support and mentorship to new hires and/or those needing refresher assistance. - Serve as co-trainer for in-services - Create and maintain relevant desktop procedures or process documentation. - Provide system and project testing support as needed. - Support team effectiveness through management of UM queues and work assignments. - May provide coverage for representation on projects in place of leadership as needed due to other priorities. What You Bring - BCBA with at least 3 years experience in clinical work - Additional direct experience in utilization management, with demonstrated success in the ECM role, meeting or exceeding metrics and quality goals. - Proven expertise in UM functions, and processes and/or discharge planning. - Must have a valid BCBA license within the US and have started application for NC license. What You’ll Get The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community - Work-life balance, flexibility, and the autonomy to do great work - Medical, dental, and vision coverage along with numerous health and wellness programs - Parental leave and support plus adoption and surrogacy assistance - Career development programs and tuition reimbursement for continued education - 401k match including an annual company contribution Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $81,068.00 - $129,708.00 Skills Clinical Decision Support (CDS), Clinical Evaluations, Clinical Experience, Clinical Support, Medical Review, Medication Management, Patient Advocacy, Patient Care Coordination, Patient Discharge Planning, Patient Education_____________________________________________________________________ JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

Remote Medical Assistant – Chronic Care & Geriatric Support Full-Time | 40 Hours per WeekMonday–FridaySchedule may vary between 7:00am–7:00pm based on assigned provider time zone About the Role We are seeking a certified and highly independent Remote Medical Assistant to provide dedicated support to mobile geriatric medical providers serving Medicare patients in the field. This work-from-home position plays a vital role in care coordination, chronic care management (CCM), and provider workflow support. You will serve as a key partner to your assigned provider, helping manage patient panels, support care plans, and ensure high-quality documentation and follow-up. This is an ideal opportunity for a Medical Assistant with experience in geriatric care, Medicare populations, or chronic disease management who thrives in a remote healthcare environment. Key Responsibilities - Provide day-to-day administrative and clinical support to assigned medical provider(s) - Coordinate patient care for a geriatric and Medicare population receiving mobile medical services - Support Chronic Care Management (CCM) activities and ongoing panel management - Communicate with patients and families regarding care plans, medication updates, follow-ups, and coordination needs - Assist with documentation, task management, and provider requests within EMR systems - Support medication reconciliation and care plan updates as directed - Monitor labs, referrals, and pending care items to reduce gaps in care - Escalate clinical concerns appropriately to the provider - Maintain accurate, timely, and compliant EMR documentation Qualifications - Active, valid Medical Assistant certification required - Experience supporting geriatric or Medicare populations strongly preferred - Prior experience in care coordination, chronic care management (CCM), or primary care preferred - Strong phone and written communication skills - Highly organized with strong time-management skills - Self-directed and comfortable working independently in a fully remote setting - Reliable high-speed internet and dedicated home workspace required What Success Looks Like - Proactive and organized support of provider workflows - Strong ownership of assigned patient panel - Timely follow-up and clear communication with patients and families - Accurate and compliant documentation - Consistent reliability, accountability, and professionalism Why Join Our Team - Fully remote healthcare position - Stable full-time schedule - Meaningful impact in geriatric and Medicare patient care - Opportunity to grow within chronic care management and mobile medical services - Collaborative, mission-driven healthcare environment Hourly range for posted region $18—$22 USD

Remote Medical Assistant – Chronic Care & Geriatric Support Full-Time | 40 Hours per WeekMonday–FridaySchedule may vary between 7:00am–7:00pm based on assigned provider time zone About the Role We are seeking a certified and highly independent Remote Medical Assistant to provide dedicated support to mobile geriatric medical providers serving Medicare patients in the field. This work-from-home position plays a vital role in care coordination, chronic care management (CCM), and provider workflow support. You will serve as a key partner to your assigned provider, helping manage patient panels, support care plans, and ensure high-quality documentation and follow-up. This is an ideal opportunity for a Medical Assistant with experience in geriatric care, Medicare populations, or chronic disease management who thrives in a remote healthcare environment. Key Responsibilities - Provide day-to-day administrative and clinical support to assigned medical provider(s) - Coordinate patient care for a geriatric and Medicare population receiving mobile medical services - Support Chronic Care Management (CCM) activities and ongoing panel management - Communicate with patients and families regarding care plans, medication updates, follow-ups, and coordination needs - Assist with documentation, task management, and provider requests within EMR systems - Support medication reconciliation and care plan updates as directed - Monitor labs, referrals, and pending care items to reduce gaps in care - Escalate clinical concerns appropriately to the provider - Maintain accurate, timely, and compliant EMR documentation Qualifications - Active, valid Medical Assistant certification required - Experience supporting geriatric or Medicare populations strongly preferred - Prior experience in care coordination, chronic care management (CCM), or primary care preferred - Strong phone and written communication skills - Highly organized with strong time-management skills - Self-directed and comfortable working independently in a fully remote setting - Reliable high-speed internet and dedicated home workspace required What Success Looks Like - Proactive and organized support of provider workflows - Strong ownership of assigned patient panel - Timely follow-up and clear communication with patients and families - Accurate and compliant documentation - Consistent reliability, accountability, and professionalism Why Join Our Team - Fully remote healthcare position - Stable full-time schedule - Meaningful impact in geriatric and Medicare patient care - Opportunity to grow within chronic care management and mobile medical services - Collaborative, mission-driven healthcare environment Hourly range for posted region $18—$22 USD

Company Overview At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth. Be part of a team that makes a real difference. Job Description This is a Part - Time role and you must possess a CRC Certification This position is mostly remote but you must be located in Michigan as you will travel about 30% of the time Perks: Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers’ compensation case management training. Join our compassionate team and help make a positive difference in an injured person’s life. As a qualified Vocational Case Manager, you will provide counseling and expertise to individuals with employment-related psychological or physical challenges, assess readiness for employment, skills, and identify vocational alternatives that are within an individual’s current skill and functional ability levels. In this role, you will: - Demonstrate advanced knowledge, skills, and competency in the application of vocational case management standards of practice. - Conduct comprehensive vocational assessments to recommend and coordinate injured worker participation in various programs, activities, and services designed to prepare them for reentry in the workplace. - Review assessments, interviews and tests, alongside medical information to formulate vocational goals. - Collaborate with treating physicians and therapists to advocate for and coordinate medical assessments to aid in counseling the injured worker on vocational alternatives. - Work with past or present employers and employment facilities to advocate for modifications of job duties based on medical limitations and the individual’s functional assessment. - Research and recommend training programs to individuals, and coordinate/monitor participation. - Facilitate return to work by providing job search skills to injured workers. - Serve as representative of the Company in communications with attorneys, insurance carriers, physicians, employers, and injured workers. - Perform other duties such as coordinate appointments, maintain files, prepare reports, communicate with outside parties, provide expert testimony, and potentially train new staff. Qualifications - Education: Associate Degree or Bachelor’s Degree in vocational evaluation, special education, behavioral psychology, or related field required. Master’s level and/or advanced study strongly preferred or as required by state law. - Certifications, Licenses, Registrations: CRC certification required. Actual certification preferred, or as required by state law. - Experience: Prior industry-related experience in workers’ compensation required. - Skills: Must meet all vocational case management eligibility requirements of the state/jurisdiction of hire. Ability to work independently. Ability to mentor and/or train other case managers as needed or as part of a development opportunity. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills. Excellent interpersonal skills. - Internet: Must have reliable internet. - Transportation: Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography. Benefits We’re committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $40-45 hourly. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics. The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability. #LI-MC1​​​​​​​ Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers’ Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager