Case Manager (Shelby County)

BlueCross BlueShield of Tennessee • Memphis, TN

1d • Remote

About The Position

The SelectCommunity team at BCBST is seeking a compassionate and dedicated RN Case Manager to join our team in Shelby County. We take a person-centered approach, partnering closely with each member’s Circle of Support to ensure their individual needs are met. In this role, you will serve TennCare members with Intellectual and Developmental Disabilities who are enrolled in a 1915(c) Waiver program. This position also involves coordinating care across multiple partners, guiding members and providers through benefit programs, and helping manage complex situations where additional support is needed. You will oversee challenging cases to ensure interventions are implemented effectively and services are used appropriately. If this sounds like the kind of meaningful work that energizes you, we’d love for you to apply! Preferred candidates will have experience in Case Management, Med-Surg, Home Health, or working with individuals with IDD. You will be a great match for this role if you have: 3+ years of experience in a clinical setting. An active RN license (TN or compact states). Ability to work independently from your home office with face-to-face visits required based on members acuity. Candidates must live within 50 miles of Shelby County. Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions. Various immunizations and/or associated medical tests may be required for this position. This job requires digital literacy assessment.

Requirements

• 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.
• 3 years - Clinical experience required
• PC Skills required (Basic Microsoft Office and E-Mail)
• Employees who are required to operate either a BCBST-owned vehicle or a personal or rental vehicle for company business on a routine basis will be automatically enrolled into the BCBST Driver Safety Program.
• The employee will also be required to adhere to the guidelines set forth through the program. This includes, maintaining a valid driver’s license, auto insurance compliance with minimum liability requirements; as defined in the “Use of Non BCBST-Owned Vehicle” Policy (for employees driving personal or rental vehicles only); and maintaining an acceptable motor vehicle record (MVR).
• The definition for "routine basis" is defined as daily, weekly or at regularly schedule times.

Nice To Haves

• Experience in Case Management, Med-Surg, Home Health, or working with individuals with IDD.
• 5 years - Experience in the health care industry
• 2 years experience in IDD for Select Community is required
• Excellent oral and written communication skills

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed