Case Manager (Memphis)

Job 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.
• Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions.

Job Qualifications

• Licence: 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.
• Experience: 3 years - Clinical experience required, 5 years - Experience in the health care industry.
• Skills/Certifications: Excellent oral and written communication skills, PC Skills required (Basic Microsoft Office and E-Mail).

Qualifications

• Home Health or Hospice Nursing Experience
• Pediatric Experience
• Knowledge of MTLSS Programs
• Familiarity with Community-Based Services

Benefits

• Note: This is a remote, Monday-Friday (8:00 a.m.-5:00 p.m.) role with flexibility to support member needs, however this role requires traveling to members' homes in the Memphis area and surrounding counties.
• Candidates must live within 50 miles of Memphis.

Company Information

• Sponsorship is not available for this role.
• Grade 07 BBNEIncentive Plan AEP
• Preference will be given to candidates in cost center 338.

Application Instructions

• Applying for this job indicates your acknowledgement and understanding of the following statements:
• BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.
• Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices
• BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity.
• All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered.
• No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.