DIGITAL CASE MANAGER

BlueCross BlueShield of Tennessee; Chattanooga (TN); Remote; USD 70,000 - 90,000; Full time

Job summary

BlueCross BlueShield of Tennessee is looking for a caring RN Case Manager to support individuals with chronic health issues. This fully remote position involves managing care coordination, providing support, and making a significant impact on patients' lives. Ideal candidates have clinical experience and exceptional communication skills.

Benefits

Remote Work Flexibility

Health and Wellness Programs

Qualifications

• Active Registered Nurse (RN) license in Tennessee required.
• 3 years of clinical experience in healthcare required.
• 5 years experience preferred in case management or related field.

Responsibilities

• Manage care for members with chronic and complex conditions.
• Coordinate health care delivery and benefits programs.
• Ensure effective implementation of case management interventions.

Skills

Customer Service

Digital Literacy

Communication

Education

Bachelors in Nursing

Tools

Microsoft Office

Email

Job description

BlueCross BlueShield of Tennessee (BCBST) is seeking a caring and committed RN Case Manager to join our Dedicated Advocacy Case Management Team. In this role, you will manage dedicated account members with chronic and complex medical conditions, including assisting with various care coordination needs. Our ideal candidate will thrive on supporting others through difficult times and will find satisfaction in building meaningful connections with members over the phone.

You will be a great match for this role if you have experience in Case Management, ICU, Med-Surg, Oncology, or Home Health Care, exceptional customer service skills, and strong digital skills. This is an opportunity to make a meaningful impact every day by helping individuals lead healthier, more fulfilling lives through comprehensive care management.

Note : RN Case Managers must be available for occasional late shift rotation (9 am to 6 pm (Central) / 10 am to 7 pm (Eastern) and be open to obtaining additional non-compact RN licenses as requested.

Although we are based in Chattanooga, TN, this is a fully remote role.

• Job Responsibilities
• Supporting utilization management functions for more complex and non-routine cases as needed.
• Serving as a liaison between members, providers and internal / external customers in coordination of health care delivery and benefits programs.
• Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits
• Performing the essential activities of case management : assessment : planning, implementation, coordinating, monitoring, outcomes and evaluation.
• Digital positions must have the ability to effectively communicate via digital channels and offer technical support.
• Effective 7 / 22 / 13 : This Position requires an 18 month commitment before posting for other internal positions.
• Various immunizations and / or associated medical tests may be required for this position.
• This job requires digital literacy assessment.
• Job Qualifications

License_

• Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.

Experience_

• 3 years - Clinical experience required
• 5 years - Experience in the health care industry
• For Select Community & Katie Becke 2 years experience in IDD for Select Community is required

SkillsCertifications_

• Currently has a Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire.
• For Select Community & Katie Becke In addition to CCM, Certification in Developmental Disabilities Nursing (CDDN) is required at hire, or must be attained within 3 years.
• Excellent oral and written communication skills
• PC Skills required (Basic Microsoft Office and E-Mail)

Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis

• will be automatically enrolled into the BCBST Driver Safety Program. The employee will also be required to adhere to the guidelines set forth through the program. This includes, maintaining a valid drivers license, auto insurance compliance with minimum liability requirements; as defined in the Use of Non BCBST-Owned Vehicle Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR).
• The definition for routine basis is defined as daily, weekly or at regularly schedule times.
• Number of Openings Available :
• Worker Type :

Employee

• Company :

BCBST BlueCross BlueShield of Tennessee, Inc.

• Applying for this job indicates your acknowledgement and understanding of the following statements :

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin,citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies / Notices may be found by reviewing the following page :

BCBST's EEO Policies / Notices (https : / / www.bcbst.com / docs / equal-employment-opportunity.pdf)

• BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR / Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.
• Tobacco-Free Hiring Statement

To further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community.

• All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco / nicotine test.
• An individual whose post offer screening result is positive for illegal drugs or tobacco / nicotineand / or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results.

Resources to help individuals discontinue the use of tobacco / nicotine products include smokefree.gov or 1-800-QUIT-NOW.

About Us

As Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health since 1945. More than that, we're your neighbors and friends fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow.

BCBST is a remote-first organization with many employees working primarily from their homes. Each position within the company is classified as either fully remote, partially remote, or office based.

BCBST hires employees for remote positions from across the U.S. with the exception of the following states : California, Massachusetts, New Hampshire, New Jersey, and New York. Applicants living in these states may move to an approved state prior to starting a position with BCBST at their own expense. If the applicant moves to Chattanooga, TN, they may be eligible for relocation benefits.

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Case Manager • Chattanooga, TN, United States