Summary
 

We are currently hiring for an Intensive Care Management Coordinator-Behavioral Health to join BlueCross BlueShield of South Carolina. In this role as an Intensive Care Management Coordinator-Behavioral Health, you will serve as an Intensive Case Manager (ICM) for members identified with specific conditions, assist with implementation of case management activities/programs for BlueCross BlueShield of South Carolina (BCBSSC), BlueChoice and/or Healthy Blue Medicaid members.

Description
 

Location:

This position is full time (40 hours/week) Monday-Friday from 8:00am-5:00pm EST and will be fully remote, with required member-facing patient visits within the South Carolina region.

• This position offers mileage reimbursement with a current travel limit of 3-hours one way. We offer mileage reimbursement after mile 50 with a reimbursement rate of 0.7 per mile.

What You Will Do:

• Perform primary functions of assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy of assigned members. In person contact with the member is required.  Collaborate and communicate with the member, member's family/caregiver and other healthcare professionals involved in the member’s care.  Ensure care coordination and case management activities are aligned with members' risk levels and identified strengths, preferences, needs and desired outcomes.  Assist with implementation of health management activities/programs for membership. Coordinate all aspects of assigned programs. Follow and assist with updates to updates of established procedures. Complete in-person assessments in the member’s residence or least restrictive environment.  Participate in meetings concerning the member’s care. Utilize all data systems containing patient information and documents information appropriately.

• Assist with development of strategies to increase effectiveness of and participation in health management programs. Establish and /maintain effective communications with provider network, group representatives and members.

• Conduct research and analysis of reports (monthly, quarterly, annually). Adhere to NCQA requirements, state/federal regulations and CMSA standards.  Monitor member compliance and success rate.

• Assist with identification of areas for which there is a need for health management programs. Monitor quality indicators and identify programs to positively impact areas where improvement is warranted. Develop patient/provider educational materials for members/providers. Perform other duties as assigned.

To Qualify for This Position, You'll Need the Following:

• Required Education: Bachelor's degree from an accredited university or college in Nursing, Health Administration, Health Promotion, Exercise Science, Education/Training, Social Work, or health-related field with a minimum of 45 documented training hours related to specialty area issues and treatment.

• Degree Equivalency: If Behavioral Health Intensive Case Manager: 4-year degree in nursing, psychology, social work, early childhood education, child development or a related field with minimum of 45 documented training hours related to specialty area issues and treatment.  If Maternal Health Intensive Case Manager: 4-year degree in Health Promotion or related field OR 2-year degree and 2 years’ experience in healthcare environment or as a Certified Childbirth Educator/Prenatal Educator, OR graduate of an approved LPN program and 2 years’ experience in maternity management healthcare environment. If Medical Health Intensive Case Manager: 4-year degree in Health Promotion, Exercise Science, or re