Case Manager

Blue Cross of Idaho; Carmel (IN); On-site; USD 73,000 - 103,000; Full time

Benefits offered by this job

Paid time off

Paid holidays

Medical insurance

Dental insurance

Vision insurance

401(k) matching

Life insurance

Disability coverage

Education reimbursement

Employee assistance plan (EAP)

Adoption assistance

Paid family leave

Job summary

Blue Cross of Idaho is seeking a Care Manager to effectively care‑manage members through a collaborative process. This role involves independent work with limited supervision, evaluating health needs, planning and implementing interventions, and coordinating with physicians and the care team to optimize outcomes and costs.

The candidate will conduct comprehensive assessments, develop plans, educate members, and track outcomes while mentoring staff and ensuring continuity across care levels.

Qualifications

• 3 years' relevant experience.
• Associates Degree in Nursing or Bachelor's Degree in Social Work, or equivalent work experience.
• Must hold one of the following: Valid unrestricted Idaho RN License or Idaho Social Worker License.
• Preferred: Masters in Social Work.
• Preferred: Bachelor's Degree in Nursing.

Responsibilities

• Conducts an evaluation of the members' current status including physical, mental, and social determinants of health.
• Identifies, plans, implements, and evaluates appropriate health care interventions in conjunction with the physician treatment plan.
• Collaborates with member, family, healthcare provider and team members to coordinate care and guide members to the most appropriate, cost effective resources.
• Collaborates with members, providers, staff, and stakeholders to assure continuity for members throughout different levels of care they may require.
• Provides education and referrals to appropriate community resources.
• Tracks and reports quantifiable impact, quality of care, and/or quality of life improvements as measured against long and short-term goals.
• Acts as a peer mentor for training new personnel as well as on-going training for staff.
• Conducts quality review of work completed by peers and new hires.
• Performs other duties and responsibilities as assigned.

Education

Associates Degree in Nursing

Bachelor's Degree in Social Work

Job description

Join Blue Cross of Idaho's growing Healthcare Operations team! In this role, care managers will effectively care-manage members utilizing a collaborative process. Work independently and under limited supervision. Assess, plan, implement, monitor, and evaluate the options and services required to meet an individual's health needs using communication and available resources to promote quality, cost-effective outcomes.

What we are looking for in Care Manager:

• Experience: 3 years' relevant experience
• Education: Associates Degree in Nursing or Bachelor's Degree in Social Work; or equivalent work experience (Two years' relevant work experience is equivalent to one-year college)
• Licenses/Certifications: Must hold one of the following:
  • Valid unrestricted Idaho Registered Nurse License
  • Valid unrestricted Idaho Social Worker License
• Preferred Requirement:
  • Masters in Social Work
  • Bachelors Degree in Nursing

What your day may look like:

• Conducts an evaluation of the members' current status including physical, mental, and social determinants of health.
• Identifies, plans, implements, and evaluates appropriate health care interventions in conjunction with the physician treatment plan.
• Collaborates with member, family, healthcare provider and team members to coordinate care and guide members to the most appropriate, cost effective resources.
• Collaborates with members, providers, staff, and stakeholders to assure continuity for members throughout different levels of care they may require.
• Provides education and referrals to appropriate community resources.
• Tracks and reports quantifiable impact, quality of care, and/or quality of life improvements as measured against long and short-term goals.
• Acts as a peer mentor for training new personnel as well as on-going training for staff.
• Conducts quality review of work completed by peers and new hires.
• Performs other duties and responsibilities as assigned.

As of the date of this posting, a good faith estimate of the current pay range is $73,321 - $102,650. The position is eligible for an annual incentive bonus (variable depending on company and employee performance). The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data. At Blue Cross of Idaho, it is not typical for an individual to be hired at or near the top range for the position. Compensation decisions are dependent on factors and circumstances at the time of offer.

We offer a robust package of benefits including paid time off, paid holidays, community service and self-care days, medical/dental/vision/pharmacy insurance, 401(k) matching and non-contributory plan, life insurance, short and long term disability, education reimbursement, employee assistance plan (EAP), adoption assistance program and paid family leave program. We will adhere to all relevant state and local laws concerning employee leave benefits, in line with our plans and policies.

Applicants must be legally authorized to work in the United States at the time of application and throughout employment. The company does not provide employment-based visa sponsorship for this position.

Reasonable accommodations To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Blue Cross of Idaho will extend reasonable accommodations to qualified individuals with disabilities who are otherwise not able to fully use electronic and online job application systems.

Equal Opportunity is the Law EEO is the Law Supplement E-Verify Pay Transparency

Blue Cross of Idaho has taken our role as an Idaho-based health insurance company to heart since 1945. As a not-for-profit, we are driven to help connect Idahoans to quality and affordable healthcare while building strong networks and services. We aim to create a brighter future for all with the help of customer-centric professionals.

Your Health and Wellness Matters At Blue Cross of Idaho, we care about the health and well-being of our employees. Our benefits aim to help make your life easier, healthier and more balanced.

Your Career Development Matters We believe in employee growth, which is why we offer training, tools and numerous resources to assist with professional development.

Your Community Matters Our employees care deeply about Idaho. We work together to positively impact communities throughout Idaho, and contribute our time through volunteering.