Integrated Care Manager - Hybrid Care Coordinator Expert

Blue Cross Blue Shield of Arizona; Phoenix, Northern (AZ, KY); Hybrid; USD 70,000 - 100,000; Full time

Job summary

Blue Cross Blue Shield of Arizona is seeking a qualified healthcare professional for a case management role focused on coordinating care and ensuring continuity of services for members under their benefit plan.

The position emphasizes collaboration with providers, data review, and adherence to state and federal requirements, with flexible Workability hybrid options and a requirement for Arizona residency.

Qualifications

• Required Work Experience: 2 years of full-time equivalent experience in direct clinical care to consumers.
• Required Education: Associate’s Degree, Nursing Diploma, Master’s in Behavioral Health, or higher.
• Required Licenses: Active, current, unrestricted license in Arizona as a behavioral health professional or RN.
• Required Certifications: Within 4 years, obtain one of CCM, CDMS, CMAC, CMC, CRC, CRRC, COHN, RN-C, or RN-BC.

Responsibilities

• Assess and collect member data from all care settings.
• Collaborate with providers, members, and families to implement care plans.
• Handle high-volume health insurance-related customer calls daily.
• Explain benefits, coverage, eligibility, claims, programs, and networks.
• Review medical records and determine medical necessity based on criteria and benefits.

Skills

Case management

Care coordination

Healthcare policy

Interpersonal skills

Documentation

Education

Associate’s Degree

Post High School Nursing Diploma

Master’s Degree in Behavioral Health

Ph.D./Psy.D.

Job description

Blue Cross Blue Shield of Arizona is seeking a qualified healthcare professional for a case management role focused on coordinating care and ensuring continuity of services for members under their benefit plan.

The position emphasizes collaboration with providers, data review, and adherence to state and federal requirements, with flexible Workability hybrid options and a requirement for Arizona residency.