Intensive Care Management Coordinator

BlueCross BlueShield of South Carolina; South Carolina; Remote; USD 50,000 - 80,000; Full time

Job summary

An established industry player is seeking an Intensive Care Management Coordinator to provide exceptional case management for members with specific health conditions. This full-time, fully remote role involves conducting assessments, coordinating care, and collaborating with healthcare professionals to ensure effective health management. You will play a crucial role in enhancing member participation in health programs and ensuring compliance with regulatory standards. Join a team that values diversity and inclusion, and be part of a mission-driven organization that makes a real difference in the lives of its members.

Benefits

Subsidized health plans

Dental plans

Vision plans

401k with company match

Life insurance

PTO

Educational assistance

Qualifications

• Bachelor's degree in a health-related field with specialized training.
• 3 years of experience with individuals having specific health conditions.

Responsibilities

• Conduct assessments and coordinate care for assigned members.
• Develop strategies to enhance participation in health management programs.

Skills

Proficiency with Microsoft Office

Understanding of insurance and benefit programs

Knowledge of quality improvement

Ability to work independently

Decision-making skills

Education

Bachelor's degree in Nursing

Bachelor's degree in Health Administration

Bachelor's degree in Social Work

Job description

Join to apply for the Intensive Care Management Coordinator role at BlueCross BlueShield of South Carolina

Get AI-powered advice on this job and more exclusive features.

Summary

Serve as an Intensive Case Manager (ICM) for members identified with specific conditions. Assists with implementation of case management activities/programs for BlueCross BlueShield of South Carolina (BCBSSC), BlueChoice and/or Healthy Blue Medicaid members.

Description

This position is full time (40 hours/week) Monday-Friday from 8:30am-5:00pm EST and will be fully remote, with required member-facing patient visits within the South Carolina region.

What You Will Do

1. Perform assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy for assigned members. Conduct in-person contact as required. Collaborate with members, their families/caregivers, and healthcare professionals to ensure aligned care management activities. Complete assessments in members' residences or least restrictive environments. Use all data systems appropriately.
2. Develop strategies to enhance participation in health management programs. Maintain effective communication with provider networks, group representatives, and members.
3. Analyze reports (monthly, quarterly, annually). Ensure compliance with NCQA, state/federal regulations, and CMSA standards. Monitor member adherence and success rates.
4. Identify areas needing health management programs. Monitor quality indicators and develop educational materials for members and providers. Perform other duties as assigned.

Qualifications

• Bachelor's degree in Nursing, Health Administration, Health Promotion, Exercise Science, Education/Training, Social Work, or a related health field, with at least 45 hours of specialized training.
• Relevant work experience: minimum 3 years working with individuals with specific health conditions; 2 years if holding a master's degree.
• Skills: Proficiency with Microsoft Office, understanding of insurance and benefit programs, knowledge of quality improvement, and ability to work independently and make sound decisions.
• Licenses: Active, unrestricted RN, LPN, Social Worker, or relevant license as specified.

Benefits

• Subsidized health, dental, and vision plans
• 401k with company match
• Life insurance, PTO, educational assistance, and more

Additional Information

BlueCross BlueShield of South Carolina values diversity and inclusion, offering accommodations for individuals with disabilities and other needs. Equal opportunity employer.