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Nurse Case Manager (Madison County, Gibson County, Dyer County, Obion County, or Weakley County )

Role overview

Qualifications

  • Registered Nurse (RN) with active license in the state of Tennessee
  • 5 years of experience in the healthcare field
  • 3 years of clinical experience
  • 2 years experience in IDD for Select Community

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 to ensure effective implementation of interventions and efficient utilization of benefits
  • Performing essential activities of case management: assessment, planning, implementation, coordinating, monitoring, outcomes and evaluation

Key facts

Other skills

  • Digital Literacy
  • Communication
  • Microsoft Office
  • Non-Verbal Communication

About the company

BlueCross BlueShield of Tennessee logo

BlueCross BlueShield of Tennessee

Insurance

As Tennessee's largest health plan, we've been helping Tennesseans find their own unique paths to good health for more than 70 years. More than that, we're your neighbors and friends – fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow. Our mission is simple: peace of mind through better health. We're an independent, not-for-profit, locally governed health plan company – meaning we live and work alongside our Tennessee business customers and plan members. Our 6,000 employees across the state have built our strong reputation for integrity, excellent service and community leadership. But we are also part of the BlueCross BlueShield Association, a nationwide association of health care plans. Because of this, our plan members have access to the same quality health benefits while traveling or living out of state that they have while in Tennessee. Β© 2018 BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association.

Company details

Company typeXLarge
IndustryInsurance
Company size5001 - 10000

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Job description

SelectCommunity at BCBST is seeking a Registered Nurse Case Manager who is compassionate about case management,  advocating for social, emotional, functional, mental, behavioral, and physical health of those who are intellectually and developmentally disabled. 

In this role, the SelectCommunity Nurse Care Manager (NCM) assesses members’ current status, facilitates coordination of long-term services and supports under their insurance benefits and benefits under Department of Disability and Aging. The SelectCommunity NCM collaborates with members, caregivers, conservators, and providers to develop individual, integrated plans of care based on health needs, while monitoring progress for members with multiple levels of acuity.

This role requires telephonic contacts and in person home visits with members on at least a monthly basis and as required by TennCare Contract. 

You will be a great match for this role if you have an active RN license in the state of Tennessee along with 5 years of experience in the healthcare field (including 3 years of clinical experience). Additionally, we’re seeking candidates who reside in Madison County, Gibson County, Dyer County, Obion County, or Weakley County TN as travel is required to meet with members.

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. 
  • Various immunizations and/or associated medical tests may be required for this position.
  • This job requires digital literacy assessment. 

Job Qualifications

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.

Experience

  • 3 years - Clinical experience required
  • 5 years - Experience in the health care industry
  • For Select Community & Katie Beckett: 2 years experience in IDD for Select Community is required

Skills\Certifications

  • Excellent oral and written communication skills
  • PC Skills required (Basic Microsoft Office and E-Mail)

Grade: BBEX 10

Incentive Plan AEP

Number of Openings Available

0

Worker Type:

Employee

Company:

VSHP Volunteer State Health Plan, Inc

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.

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Marcus Rivera

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