Integrated Care Manager — Hybrid Care Navigator

Blue Cross Blue Shield of Arizona; Phoenix (AZ); Hybrid; USD 60,000 - 90,000; Full time

Job summary

Blue Cross Blue Shield of Arizona is seeking a full-time Care Manager to promote continuity of care, assess needs, coordinate services, and monitor outcomes within a collaborative care framework. The role emphasizes clinical expertise across behavioral health and medical care, with required licensure and professional certifications.

The position supports a hybrid work model with onsite requirements in AZ; residency within AZ is needed for remote work eligibility, and ongoing professional

Qualifications

• 2 year(s) of experience in full-time equivalent of direct clinical care to the consumer.
• Active, current, and unrestricted license to practice in the State of Arizona as a behavioral health professional or as an RN under the NLC.
• Within 4 years of hire, hold a certification in case management from CCM, CDMS, CMAC, CMC, CRC, CRRC, COHN, RN(C), or RN/BC.

Responsibilities

• Assess and collect data related to the member from all care settings. Interview and collaborate with case-related providers, member and family to implement the care plan.
• Answer a diverse and high volume of health insurance related customer calls on a daily basis.
• Explain information concerning the organization’s services, including benefits, eligibility, claims, and networks.
• Analyze medical records and apply medical necessity criteria to determine the appropriateness of benefit requests.
• Present status reports on all cases to the manager and, when indicated, to the medical director.
• Collaborate with internal and external teams to resolve inquiries and ensure quality care.
• Maintain records per department policy and meet/maintain accreditation requirements.

Skills

Direct clinical care experience

Education

Associate's Degree in general field

Master's or Doctoral degree in Behavioral Health

Job description

Blue Cross Blue Shield of Arizona is seeking a full-time Care Manager to promote continuity of care, assess needs, coordinate services, and monitor outcomes within a collaborative care framework. The role emphasizes clinical expertise across behavioral health and medical care, with required licensure and professional certifications.

The position supports a hybrid work model with onsite requirements in AZ; residency within AZ is needed for remote work eligibility, and ongoing professional