Behavior Health Case Manager

BlueCross BlueShield of Tennessee • Nashville, TN

8h • Remote

About The Position

Our BlueCare team at BCBST is looking to hire a Behavioral Health Case Manager to support members within the Intellectual and Developmental Disability (IDD) population. You will manage a mixed caseload of some set members and some short-term cases to address current care coordination needs. In this role, you will work collaboratively as part of a specialized team focused on IDD support and build ongoing, trusted relationships with members, their caregivers, and providers to ensure effective care coordination and strong member advocacy. All services are delivered remotely, supporting members located throughout the state of Tennessee. To be successful in this role, in addition to meeting the core job requirements, you will bring prior case management or care coordination experience, with experience supporting the IDD population strongly preferred. You are open to learning and able to be trained to support IDD members if your direct experience is limited, and you are comfortable managing a consistent caseload with diverse and complex needs. Strong organizational skills and the ability to work independently in a fully remote environment are essential for success in this role. Additional Notes Candidates will need to reside in the state of Tennessee. Sponsorship is not available for this position. At BCBST, we foster a culture where innovation is encouraged, including the responsible use of AI-enabled tools to support everyday work. As roles become more advanced, employees are expected to leverage AI, guided by established workflows, templates, and policies, to improve how we serve our members.

Requirements

• Current, active unrestricted Tennessee license in Nursing (RN) or behavioral health field (Master's level or above) (Ph.D., LCSW/LMSW, LLP, MHC, LPC, etc.) required. RN may hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.
• 3 years - Clinical behavioral health / substance use disorder experience required
• 1 year - Must be knowledgeable about community care resources and levels of behavioral health care available.
• Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
• Independent, Sound decision-making and problem-solving skills
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills
• Strong analytical skills
• Positive relationship building skills and ability to engage and motivate health behaviors in diverse populations
• Ability to quickly identify and prioritize member needs and provide structured and focused support and interventions
• Experience with Motivational Interviewing Techniques and Adult Learning Styles

Nice To Haves

• Prior case management or care coordination experience, with experience supporting the IDD population strongly preferred.
• Open to learning and able to be trained to support IDD members if your direct experience is limited.
• Comfortable managing a consistent caseload with diverse and complex needs.
• Strong organizational skills and the ability to work independently in a fully remote environment are essential for success in this role.

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.
• Perform case management activities in community settings including face to face with members as required.
• Various immunizations and/or associated medical tests may be required for this position.
• Testing/Assessments will be required for Digital positions.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees