ACHN RN Care Manager

Blue Cross and Blue Shield of Alabama; Alabama; On-site; USD 55,000 - 75,000; Full time

Job summary

A regional health insurance provider in Alabama is seeking a Registered Nurse to perform care management for Medicaid recipients. The role includes developing effective care plans, conducting meetings with patients, and requires an active RN license. Candidates must have at least two years of experience in a clinical setting and strong communication skills. This is a full-time entry-level position with a focus on community health.

Qualifications

• Must have two years of recent experience in a clinic or hospital.
• Active Alabama license as a Registered Nurse.
• Experience working with low-income and diverse populations.

Responsibilities

• Perform care management for Medicaid recipients.
• Develop and act upon care plans in a timely manner.
• Conduct face-to-face meetings with recipients.

Skills

Verbal and written communication skills

Care coordination

Decision making

Documenting electronic case records

Education

Bachelors of Science in Nursing or Associate Degree in Nursing

Job description

Overview

Our subsidiary is responsible for coordinating care for healthy eligible individuals, those with multiple chronic conditions, pregnant women, and men and women needing family planning. The goal of the program is to ensure an effective and efficient delivery of care. This area works with low income populations to improve the quality of care programs and community outreach.

Primary Responsibilities

This position performs care management for recipients assigned by the State of Alabama Medicaid Office. Our subsidiary provides this care management for recipients enrolled in programs designated by State of Alabama Medicaid. Performance guidelines are in place to ensure that sound care plans are developed and acted upon in a timely manner so as to improve the recipient’s overall health. This care management frequently involves face-to-face meetings with the recipients to gain a full understanding of their challenges. This position will primarily provide services to home care and community based populations, identified as needing care management and transitional services from inpatient facilities.

Summary Of Qualifications

• Bachelors of Science in Nursing or Associate Degree or Diploma in Nursing

Specific Requirements For Associate Degree In Nursing (ADN) Only

• Must have two (2) years of recent experience working in a clinic setting or combined hospital experience; and
• Minimum on one (1) year experience in care coordination/case management working with low-income and diverse populations; must include experience working with individuals in Medicaid populations receiving care coordination/case management services.
• Active Alabama license in good standing as a Registered Nurse (RN)
• Must live and work within the region or adjoining county
• Have strong verbal and written communication skills to encourage and engage recipients in plan of care
• Ability to sufficiently document electronic case records including writing effective care plans and SMART goals
• Ability to manage a heavy caseload
• Experience analyzing clinical situations and making informed decisions
• Experience in a position demonstrating exceptional written, verbal and interpersonal communications
• Experience in a position exercising independent judgement and decision making
• Experience in a position working with medical providers and/or community resource agencies
• Willingness to travel as required for the job
• Two years of complex pediatric experience preferred
• Experience working in a home setting as a Case Manager or Care Coordinator preferred
• Knowledge of Alabama Medicaid regulations and guidelines preferred
• Knowledge of community based agencies and resources is preferred
• Experience working in a behavioral health hospital or residential facility preferred

Terms and Agreements

By submitting a job application, I attest that all information to the best of my knowledge is true and accurate. Furthermore, I understand that any information provided by me throughout the job application process is subject to verification including, but not limited to work experience, education, assessment (test) and interviews.

We appreciate your interest in “The Company. The Company does not discriminate in hiring or employment on the basis of race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetics, status as a disabled or protected veteran, or because of citizenship status in the case of a citizen or intending citizen. No question on this application is intended to secure information to be used for such discrimination.

Seniority level

• Entry level

Employment type

• Full-time

Job function

• Health Care Provider

Industries

• Insurance

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