Intensive Care Management Coordinator - Behavioral Health

BlueCross BlueShield of South Carolina; Charleston (SC); Remote; USD 50,000 - 90,000; Full time

Job summary

An established industry player is seeking an Intensive Care Management Coordinator-Behavioral Health to join their remote team. In this pivotal role, you will serve as a key case manager for members with specific health conditions, conducting assessments and facilitating care coordination. You will collaborate with healthcare professionals to ensure members receive the best possible support and resources. This position offers a dynamic work environment where your contributions will directly impact the health and well-being of individuals in the community. Join this forward-thinking organization and make a difference in the lives of many.

Benefits

Health Plans

401k with Match

Life Insurance

PTO

On-site Amenities

Education Assistance

Discounts

Qualifications

• Bachelor's degree in Nursing, Health Administration, or related field required.
• Minimum 3 years of experience with specified health conditions.

Responsibilities

• Coordinate care for members, ensuring alignment with their needs and outcomes.
• Develop strategies to enhance program effectiveness and participation.

Skills

MS Office Proficiency

Customer Service

Analytical Skills

Decision-Making

Communication

Education

Bachelor's Degree in Nursing or related field

Specialized Training (45 hours)

Job description

Summary

We are currently hiring for an Intensive Care Management Coordinator-Behavioral Health to join BlueCross BlueShield of South Carolina. In this role, as an Intensive Care Management Coordinator-Behavioral Health, 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 8:00am-5:00pm EST, and will be fully remote, with required member-facing patient visits within the South Carolina region.

• Travel Reimbursement: Mileage reimbursement is offered with a current travel limit of 3 hours one way. Reimbursement begins 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. Conduct in-person contact with members, collaborating with their families/caregivers and healthcare professionals. Ensure activities are aligned with members' risk levels, strengths, needs, and outcomes. Assist with health management activities and coordinate program aspects. Complete assessments in members' residences or least restrictive environments. Participate in care meetings and utilize all data systems appropriately.

• Develop strategies to enhance program effectiveness and participation. Maintain effective communication with providers, group representatives, and members.

• Research and analyze reports (monthly, quarterly, annually). Ensure compliance with 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:

• 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 by role, e.g., 4-year degree in relevant fields with training hours, or specific experience in maternity, asthma, or wellness coaching.

• Work Experience: Minimum of 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, quality improvement, independent work, decision-making, customer service, communication, analytical skills, discretion, and willingness to drive and work nights/weekends. Knowledge of evidence-based assessments and case management standards.

• Licenses and Certifications: Active, unrestricted RN, LPN, or social work license as applicable, in the U.S. and in the state of hire or with a multistate compact.

Benefits:

Our comprehensive benefits include health plans, 401k with match, life insurance, PTO, on-site amenities, education assistance, and discounts.

Additional Information:

We value diversity and inclusion, and are committed to equal employment opportunity and providing reasonable accommodations for individuals with disabilities or religious needs. For accommodations, contact [e-mail] or call 800-288-2227, ext. 47480.

We participate in E-Verify and adhere to pay transparency laws. More information is available on our website and relevant state notifications.