Case Management Health Support Coordinator

Blue Cross Blue Shield of Minnesota•Eagan, MN

1d•Remote

About The Position

About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You'll Have Supports clinical case managers by preparing non-clinical case information for review. Responsibilities include entering member information, identifying high-cost cases, creating program cases in the system, and assigning them to the clinical queue.

Requirements

4+ years of experience in related role or 2+ years internal experience.
High school diploma (or equivalent)

Nice To Haves

Ability to communicate detailed information to diverse audiences, actively listen to understand varied perspectives, and facilitate alignment on operational priorities.
Ability to analyze complex operational issues, evaluate tradeoffs, and collaborate with stakeholders to reach effective, sustainable solutions.
Ability to organize work across multiple assignments, balance shifting priorities, and manage time to meet commitments while supporting team coordination.
Healthcare experience and/or knowledge of the managed care and health care/insurance industry.
Experience with healthcare regulations including Mental Health Parity (MHPAEAA) Federal Regulatory requirements and applicable state laws.
Medicaid and commercial insurance experience.
Understanding of population health management trends, clinical program design, and healthcare market dynamics.
Experience developing and implementing strategy and strategic initiatives.
Process improvement and ability to implement tools or systems that improve team efficiency and accuracy.
Understanding of medical claims and coding.

Responsibilities

Perform clerical tasks to prepare cases for clinical review, securing clinicians can focus on member care.
Conduct phone number searches using internal systems and provider outreach.
Creates and assigns cases for clinical review, confirming accurate routing to the appropriate clinical queue.
Handle limited inbound calls, including transfers from MEA, and coordinate program setup or team communication via chat.
Verify and update member demographic information in the system, ensuring accuracy and identifying high-cost cases.
Recognizing workflow improvements and collaborating with leadership to implement the changes.
Receiving, researching, and prioritizing referrals through mailbox and work queues.
Performs additional responsibilities consistent with the scope and level of the role, as assigned.