What are the responsibilities and job description for the Medical Case Manager - BlueCare SelectCommunity - Roane and Morgan Counties position at BlueCross BlueShield of Tennessee?
The SelectCommunity Nurse Care Management (NCM) Program is adding a registered nurse (RN) to manage members with intellectual and developmental disabilities in Roane and Morgan Counites. In this role, you’ll have the opportunity to make a difference in the life of the individuals that 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
- 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
Skills\Certifications
- Currently has a Certified Case Manager (CCM) credential or must obtain certification 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
- PC Skills required (Basic Microsoft Office and E-Mail)
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.
Tobacco-Free Hiring Statement
To further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test. An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotine and/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results.
Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.
