BlueCross BlueShield of Tennessee logo
BlueCross BlueShield of Tennessee

Bringing peace of mind through better health to our customers and communities

Nurse Case Manager

ManagerManagerFull TimeRemoteLeadTeam 5,001-10,000Since 1952H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

7 days ago

Salary

0

Seniority

Lead

No structured requirement data.

Job Description

Nurse Case Manager

BlueCross BlueShield of Tennessee

Role Description SelectCommunity at BCBST is seeking a Registered Nurse Case Manager who is compassionate about case management, advocating for social, emotional, functional, mental, behavioral, and physical health of those who are intellectually and developmentally disabled. In this role, the SelectCommunity Nurse Care Manager (NCM) will: - Assess members’ current status. - Facilitate coordination of long-term services and supports under their insurance benefits and benefits under Department of Disability and Aging. - Collaborate with members, caregivers, conservators, and providers to develop individual, integrated plans of care based on health needs. - Monitor progress for members with multiple levels of acuity. This role requires telephonic contacts and in-person home visits with members on at least a monthly basis and as required by TennCare Contract. Qualifications - Active RN license in the state of Tennessee. - 5 years of experience in the healthcare field (including 3 years of clinical experience). - Reside in Madison County, Gibson County, Dyer County, Obion County, or Weakley County TN as travel is required to meet with members. Requirements - Support utilization management functions for more complex and non-routine cases as needed. - Serve as a liaison between members, providers, and internal/external customers in coordination of health care delivery and benefits programs. - Oversee highly complex cases identified through various mechanisms to ensure effective implementation of interventions and efficient utilization of benefits. - Perform essential activities of case management: assessment, planning, implementation, coordinating, monitoring, outcomes, and evaluation. - Digital positions must have the ability to effectively communicate via digital channels and offer technical support. - This position requires an 18-month commitment before posting for other internal positions. - Various immunizations and/or associated medical tests may be required for this position. - This job requires a digital literacy assessment. Benefits - Grade: BBEX 10 - Incentive Plan AEP - Number of Openings Available: 0

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