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Blue Cross Blue Shield of Arizona

Integrated Care Manager – Adult

Blue Cross Blue Shield of Arizona

Integrated Care Manager responsible for promoting continuity of care through collaborative assessment and planning for health care in Arizona. Requires Arizona residency and clinical care experience.

Posted 4/23/2026full-timePhoenix • Arizona • 🇺🇸 United StatesJuniorMid-LevelWebsite

About the role

Key responsibilities & impact
  • Responsible for promoting continuity of care through a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates care options and services available to members through their benefit plan that meet the individuals' health care needs while promoting quality, cost effective outcomes.
  • Responsible for case management functions but can assist with utilization management if a business need arises.
  • Assess and collect data related to the member from all care settings.
  • Interview and collaborate with case-related providers, member and family to implement the care plan.
  • Answer a diverse and high volume of health insurance related customer calls on a daily basis.
  • Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc.
  • Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests.
  • Present status reports on all cases to the manager/supervisor and, when indicated, to the medical director.
  • Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
  • Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines.
  • Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements.
  • Maintain complete and accurate records per department policy.
  • Demonstrate ability to apply plan policies and procedures effectively.
  • Collaborate with team to distribute workload/work tasks; Monitor and report team tasks; Communicate team issues and opportunities for improvement to supervisor/manager; Support/mentor team members.
  • Participate in continuing education and current development in the field of medicine, behavioral health and managed care at least annually.
  • Perform all other duties as assigned.

Requirements

What you’ll need
  • 2 year(s) of experience in full-time equivalent of direct clinical care to the consumer
  • Associate’s Degree in general field of study or Post High School Nursing Diploma or Master’s Degree in a behavioral health field of study (i.e., MSW, MA, MS, M.Ed.), Ph.D. or Psy.D
  • Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.)
  • An active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN.
  • Within 4 years of hire as a Care Manager employee must hold a certification in case management from the following certifications; Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC).

Benefits

Comp & perks
  • Health insurance
  • Flexible work arrangements
  • Professional development

ATS Keywords

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Hard Skills & Tools
case managementutilization managementdata collectionmedical record analysisbenefit request analysiscare plan implementationcustomer servicequality assurancerecord maintenanceteam collaboration
Soft Skills
communicationcollaborationproblem-solvingmentoringorganizational skillsinterpersonal skillsanalytical skillstime managementcustomer relationship managementadaptability
Certifications
Licensed Clinical Social Worker (LCSW)Licensed Professional Counselor (LPC)Licensed Independent Substance Abuse Counselor (LISAC)Licensed Marriage and Family Therapist (LMFT)Licensed Psychologist (Psy.D. or Ph.D.)Registered Nurse (RN)Certified Case Manager (CCM)Certified Disability Management Specialist (CDMS)Certified Rehabilitation Counselor (CRC)Registered Nurse Case Manager (RN,BC)