Medical Case Manager - Putnam County

BlueCross BlueShield of Tennessee; United States; Remote; USD 60,000 - 90,000; Full time

Job summary

Join a forward-thinking organization dedicated to enhancing the health and well-being of individuals with intellectual and developmental disabilities. As a Registered Nurse in the Select Community Nurse Care Management Program, you will play a vital role in managing complex cases through in-home and telephone contact. This position offers the chance to make a meaningful impact in the lives of those you serve while collaborating with a dedicated team. If you have a passion for healthcare and are committed to providing exceptional care, this is the opportunity for you.

Qualifications

• Active RN license in Tennessee or participating in Nurse Licensure Compact Law.
• 3 years of clinical experience and 5 years in healthcare required.

Responsibilities

• Support utilization management for complex cases.
• Liaison between members, providers, and customers for healthcare delivery.
• Oversee complex cases to ensure effective interventions.

Skills

Registered Nurse (RN)

Certified Case Manager (CCM)

Certification in Developmental Disabilities Nursing (CDDN)

Oral and written communication skills

PC skills (Microsoft Office and Email)

Job description

The Select Community Nurse Care Management (NCM) Program is adding a registered nurse (RN) to manage members with intellectual and developmental disabilities in Putnam County. In this role, you’ll have the opportunity to make a difference in the lives of the individuals we serve by assisting with their health needs. You’ll provide a combination of in-home and telephone contact to manage members’ care and progress for complex cases with multiple levels of need.

Note: In addition to the required clinical and health care experience, you’ll need to have 2 years’ experience in IDD for this role.

Job Responsibilities

1. Supporting utilization management functions for more complex and non-routine cases as needed.
2. Serving as a liaison between members, providers, and internal/external customers in the coordination of health care delivery and benefits programs.
3. Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions and efficient utilization of benefits.
4. Performing essential activities of case management: assessment, planning, implementation, coordination, monitoring, outcomes, and evaluation.
5. Digital positions must have the ability to effectively communicate via digital channels and offer technical support.
6. Effective 7/22/13: This position requires an 18-month commitment before posting for other internal positions.
7. Various immunizations and/or associated medical tests may be required for this position.
8. This job requires a digital literacy assessment.

Job Qualifications

License

• Registered Nurse (RN) with an active license in Tennessee or a license in the state of residence if participating in the Nurse Licensure Compact Law.

Experience

• 3 years of clinical experience required.
• 5 years of experience in the healthcare industry.
• For Select Community & Katie Beckett: 2 years of experience in IDD is required for the Select Community role.

Skills & Certifications

• Currently holds or must obtain a Certified Case Manager (CCM) credential within 2 years of hire.
• For Select Community & Katie Beckett: In addition to CCM, Certification in Developmental Disabilities Nursing (CDDN) is required at hire or must be attained within 3 years.
• Excellent oral and written communication skills.
• Proficiency in PC skills (Basic Microsoft Office and Email).

Employees operating a BCBST-owned or personal/rental vehicle for routine business will be enrolled in the BCBST Driver Safety Program, adhering to all guidelines including maintaining a valid driver’s license, auto insurance, and acceptable MVR.