Behavioral Health Case Manager

BlueCross BlueShield of Tennessee • Johnson City, TN

5d • Remote

About The Position

We are seeking two Behavioral Health Case Managers to support members utilizing Applied Behavior Analysis (ABA) services within our BlueCare Behavioral Health team. These new positions will play a key role in addressing rising utilization and costs while ensuring members continue to receive high‑quality, appropriate care. Case Managers will work directly with members, families, and providers to guide care coordination, promote effective alternatives, and support transitions for youth receiving ABA services. Key Responsibilities Engage with members, families, and providers to support appropriate use of ABA services Reduce reliance on high‑cost interventions while maintaining quality and continuity of care Coordinate care, identify alternative interventions, and facilitate provider collaboration Support family engagement and transition planning for a subset of youth Navigate the Behavior Analyst Service process and ABA Medicaid benefit requirements Assist members diagnosed with Intellectual Disability or Autism who present with safety risks, behavioral disruptions, or barriers to learning

Requirements

• License 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

• Experience with Intellectual/Developmental Disabilities (IDD) or Autism service systems
• Strong Motivational Interviewing or Trauma‑Informed Care skills
• Prior remote or telephonic case management experience
• Familiarity with managed care, utilization management, or insurance processes

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level