RN Clinical Care Guide (Case Management Exp) - Mesa (On-site)

Blue Cross Blue Shield of Arizona; Mesa (AZ); On-site; USD 65,000 - 90,000; Full time

Job summary

Prosano Health Solutions, in partnership with Blue Cross Blue Shield of Arizona, seeks an experienced Registered Nurse to join our on-site care center in Arizona. You will support members with real-time consultation, scheduling, and referrals, while contributing to high-value primary care.

This role emphasizes empathy, collaboration, and effective communication across modalities, with focus on improving health outcomes and ensuring confidentiality.

Qualifications

• Current state license to practice as a Registered Nurse.
• BLS certification is required.
• Experience with Electronic Medicare Records.
• Customer service orientation and experience.
• Strong communication across multiple modalities.
• Highly collaborative and empathetic.
• Ability to maintain confidentiality at all times.
• Active AZ fingerprint clearance card.

Responsibilities

• Support members in-person and virtually with real-time consultation, scheduling, and follow-up for referrals.
• Play a critical role in improving health outcomes and cost savings.
• Be an empathetic problem-solver and the most visible partner to patients.
• Clarify and explain referrals for specialist and diagnostic services.
• Care for end-to-end processes for referrals or specialist services.
• Lead quality programs and patient outreach to address gaps in care.
• Support members with chronic conditions by providing education, reminders, and other support.
• Handle the management and integration of office processes.
• Lead service and schedule requests on members’ behalf.
• Inform and equip Care Team with referral information and requirements.
• Be an ambassador in the local community - building relationships with providers and community organizations.
• Perform all other duties as assigned.
• Working hours include morning, night, or weekend hours

Skills

Interpersonal skills

RN license

BLS certification

Electronic Medicare Records experience

Customer service orientation

Strong communication

Collaborative

Empathy

Organization and detail orientation

Confidentiality

Education

BSN

CCM ( CCM )

Job description

About Prosano Health Solutions:

Prosano Health Solutions, in partnership with Blue Cross Blue Shield of Arizona, has launched an Advanced Primary Care model with a clear mission: To Inspire Health and Make it Easy. Our goal is to deliver affordable, convenient, and personalized care to the communities we serve. Our Advanced Primary Care model is focused on providing a signature patient experience which will raise the bar in both the delivery of care, and by ensuring health equity is top of mind. And, in every market we serve, we assure that a customized, high-value system of care is available for our members. Together, we will set the standard for how healthcare can and should be delivered in our State.

Why Join Our Team?

Here’s the fun part. We are growing our team. The team will include people who share our passion and deep commitment to taking the primary care experience to a new level. Our team is unified in providing not only comprehensive care, but a truly exceptional patient experience, leaving our patients with the lasting impression of trust and compassion. We realize we can do great things by working together and adapting processes to provide the best possible care for people. Together, we will improve the health within our communities and make a difference in people’s lives.

Working hours include morning, night, or weekend hours.

The position will require to work 100% on-site at the Care Canter location.

This Onsite work opportunity requires residency, and work to be performed, within the State of Arizona.

You Will:

• Support members both in-person and virtually with real-time consultation, education, scheduling of specialist & diagnostic referral appointments, and follow-through + follow-up of those appointments
• Play a critical role in the achievement of improved health outcomes and cost savings
• Be an empathetic problem-solver and become the most visible partner to all patients
• Clarify and explain referral for specialist and diagnostic service recommendations
• Care for end to end process as needed, for referral or specialist services
• Lead center in development and management of quality programs to include patient outreach to members in an effort to provide an elevated primary care experience with gaps in care or other clinical needs
• Support members with chronic conditions by providing education, reminders, and other support
• Handle the management and integration of office processes
• Lead service and schedule requests on member’s behalf
• Inform and equip Care Team with referral information and requirements
• Be an ambassador in the local community - building relationships with other healthcare providers, social/community organizations, and marketing partners
• Perform all other duties as assigned
• Working hours include morning, night, or weekend hours

You Have:

• Excellent interpersonal skills to include maintaining courteous, friendly and effective communications with patients, team members and external parties
• Current state license to practice as a Registered Nurse
• BLS certification
• Electronic Medicare Records experience
• Customer service orientation and experience
• Strong communication skills across multiple modalities
• Highly collaborative
• Empathy and advocacy
• Exceptional organizing skills, detail-orientation
• Must be able to maintain confidentiality at all times
• Active AZ fingerprint clearance card

Preferred Qualifications:

• Bachelor's degree in Nursing (BSN)
• Case Management Certification (CCM)
• Proficiency with other health care related software platforms
• High degree of independence, flexibility, initiative and commitment

Our Commitment

Prosano Health Solutions does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.