Intensive Care Management Coordinator

Davita Inc.; Charleston (SC); Remote; USD 60,000 - 80,000; Full time

Job summary

Davita Inc. is seeking an Intensive Care Management Coordinator-Behavioral Health to manage case activities for members, ensuring effective care coordination and support. This full-time remote role involves assessment, planning, and collaboration with families and healthcare professionals while adhering to healthcare regulations. Ideal candidates will have a Bachelor's degree in a related field alongside required professional licenses and substantial experience in health management.

Benefits

Comprehensive health plans

401(k) with company match

Education assistance

PTO and onsite amenities

Qualifications

• At least 3 years working with individuals with specified health conditions; 2 years if holding a master's degree.
• Proficiency in MS Office and understanding of insurance and benefit programs.
• Active, unrestricted RN, LPN, or social work license as specified.

Responsibilities

• Perform assessment, planning, facilitation, and coordination for assigned members.
• Ensure activities align with members' risk levels and needs.
• Monitor quality indicators and develop educational materials for members.

Skills

Customer Service

Organizational Skills

Analytical Thinking

Negotiation Skills

Education

Bachelor's degree in Nursing, Health Administration, or related field

Tools

Microsoft Office

Job description

We are currently hiring for an Intensive Care Management Coordinator-Behavioral Health to join BlueCross BlueShield of South Carolina. In this role, you will serve as an Intensive Case Manager (ICM) for members identified with specific conditions, assisting with the implementation of case management activities/programs for BlueCross BlueShield of South Carolina (BCBSSC), BlueChoice, and/or Healthy Blue Medicaid members.

Description

Location:

This position is full-time (40 hours/week), Monday-Friday, from 8:00 am to 5:00 pm EST, and will be fully remote. It requires member-facing patient visits within the South Carolina region.

• This position offers mileage reimbursement with a current travel limit of 3 hours one way. Reimbursement is provided after 50 miles at a rate of $0.7 per mile.

What You Will Do:

• Perform assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy for assigned members. In-person contact with members is required. Collaborate with members, their families/caregivers, and healthcare professionals involved in care. Ensure activities align with members' risk levels, strengths, needs, and outcomes. Assist with health management activities and coordinate program aspects. Conduct in-person assessments in members' residences or least restrictive environments. Participate in care meetings. Utilize data systems appropriately.

• Develop strategies to enhance participation in health management programs. Maintain effective communication with provider networks, group representatives, and members.

• Research and analyze reports (monthly, quarterly, annually). Adhere to NCQA, state/federal regulations, and CMSA standards. Monitor member compliance and success rates.

• Identify areas needing health management programs. Monitor quality indicators and develop educational materials for members and providers. Perform other duties as assigned.

Qualifications:

• Required Education: Bachelor's degree in Nursing, Health Administration, Health Promotion, Exercise Science, Education/Training, Social Work, or related health field with at least 45 hours of specialized training.

• Degree Equivalency: Varies based on specific case management roles, including degrees in nursing, psychology, social work, health promotion, or related fields, with relevant training hours. Specific requirements depend on the role (e.g., Behavioral Health, Maternal Health, Medical Health, Wellness Coach).

• Work Experience: At least 3 years working with individuals with specified health conditions; 2 years if holding a master's degree.

• Skills and Abilities: Proficiency in MS Office, understanding of insurance and benefit programs, knowledge of quality improvement, ability to work independently, good judgment, customer service skills, organizational skills, proficiency in spelling and grammar, persuasive and negotiation skills, analytical thinking, discretion with sensitive information, and availability to drive, including nights and weekends. Familiarity with evidence-based assessments and national case management standards.

• Software and Tools: Microsoft Office suite.

• Licenses and Certifications: Active, unrestricted RN, LPN, social work, or mental health professional licenses as specified, depending on the role.

Benefits:

Our comprehensive benefits include health plans, dental and vision coverage, 401(k) with company match, life insurance, PTO, onsite amenities, education assistance, service recognition, and discounts.

Next Steps:

After applying, our recruiting team will review your resume, possibly conduct a brief interview or email communication to verify details and salary expectations.

Equal Opportunity Statement:

We promote nondiscrimination and provide reasonable accommodations for individuals with disabilities or religious needs. For assistance, contact [e-mail] or call 800-288-2227, ext. 47480.

We participate in E-Verify and comply with pay transparency laws. We are an Equal Opportunity Employer.