BlueCross BlueShield of Tennessee

Case Manager (Memphis)

BlueCross BlueShield of Tennessee  •  Memphis, TN (Onsite)  •  4 hours ago
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Job Description

We are hiring a Home Health Case Manager at BCBST!

In this role, you will support TennCare (Medicaid) members with complex medical, functional and social needs. You will coordinate home and community-based care, conduct required home visits, and support members transitioning to adult benefits. You’ll collaborate closely with providers and internal care teams using digital tools to identify care gaps, reduce hospitalization risk, and improve outcomes.

To be successful in this role, in addition to the core job requirements, you'll bring strong clinical judgement, experience using digital tools to communication, and availability for home visits. You will be a strong candidate for this role if you have the following: home health or hospice nursing experience, pediatric experience, knowledge of MTLSS programs, and familiarity with community-based services.

Note:

  • This is a remote, Monday-Friday (8:00 a.m.-5:00 p.m.) role with flexibility to support member needs, however this role requires traveling to members' homes in the Memphis area and surrounding counties.

  • Candidates must live within 50 miles of Memphis.

  • Sponsorship is not available for this role

Job Responsibilities

  • Supporting utilization management functions for more complex and non-routine cases as needed.
  • Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs.
  • Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits
  • Performing the 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.
  • Effective 7/22/13: 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 digital literacy assessment.

Job Qualifications

License

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

Experience

  • 3 years - Clinical experience required
  • 5 years - Experience in the health care industry
  • For Select Community & Katie Beckett: 2 years experience in IDD for Select Community is required

SkillsCertifications

  • Excellent oral and written communication skills
  • PC Skills required (Basic Microsoft Office and E-Mail)

Grade 07 BBNEIncentive Plan AEP

Preference will be given to candidates in cost center 338

Number of Openings Available

1

Worker Type:

Employee

Company:

VSHP Volunteer State Health Plan, Inc

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin,citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

BlueCross BlueShield of Tennessee

About BlueCross BlueShield of Tennessee

As Tennessee's largest health plan, we've been helping Tennesseans find their own unique paths to good health for more than 70 years. More than that, we're your neighbors and friends – fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow.

Our mission is simple: peace of mind through better health.

We're an independent, not-for-profit, locally governed health plan company – meaning we live and work alongside our Tennessee business customers and plan members. Our 6,000 employees across the state have built our strong reputation for integrity, excellent service and community leadership.

But we are also part of the BlueCross BlueShield Association, a nationwide association of health care plans. Because of this, our plan members have access to the same quality health benefits while traveling or living out of state that they have while in Tennessee.

© 2018 BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association.

Industry
Finance & Insurance
Company Size
1,001-5,000 employees
Headquarters
Chattanooga, TN
Year Founded
1945
Website
bcbst.com
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