Medical Case Manager-BlueCare SelectCommunity-Knoxville (Telecommute)

Manages member care and progress for cases with multiple levels of risk.

Job Description:

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; typing and grammar skills assessment is required for these positions, in addition to standard Windows Testing.
• Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions. 

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
• Various immunizations &/or associated medical tests may be required for this position.
• 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)

Job Specific Requirements: 

**Field worker position will work from home after Chattanooga based training is complete. A minimum internet speed of 3MB per second (download) and 1MB per second(upload) is required to be eligible.  Knox or surrounding county candidates only or must be willing to relocate**

Preferred Skills:

Number of Openings Available:

1

Worker Type:

Employee

Company:

VSHP Volunteer State Health Plan, Inc

Remote-First Statement:

BCBST is a remote-first organization with many employees working primarily from their homes.  Each position within the company is classified as either fully remote, partially remote, or office based.

BCBST hires employees for remote positions from across the U.S. with the exception of the following states:  California, Massachusetts, New Hampshire, New Jersey, and New York.  Applicants living in these states may move to an approved state prior to starting a position with BCBST at their own expense.  If the applicant moves to Chattanooga, TN, they may be eligible for relocation benefits.

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

BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to 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 subsid