BlueCross BlueShield of Tennessee

Care Transition Case Manager

BlueCross BlueShield of Tennessee

full-time

Posted on:

Location Type: Hybrid

Location: Memphis • Tennessee • 🇺🇸 United States

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Job Level

Mid-LevelSenior

About the role

  • 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.

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
  • 5 years - Experience in the health care industry
  • For Select Community & Katie Beckett: 2 years experience in IDD for Select Community is required
  • Currently has a Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire.
  • For Select Community & Katie Beckett: In addition to CCM, Certification in Developmental Disabilities Nursing (CDDN) is required at hire, or must be attained within 3 years.
  • Excellent oral and written communication skills
  • PC Skills required (Basic Microsoft Office and E-Mail).
Benefits
  • Various immunizations and/or associated medical tests may be required for this position.
  • Digital literacy assessment.

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills
clinical experiencecase managementassessmentplanningimplementationcoordinatingmonitoringoutcomes evaluation
Soft skills
communication skillsinterpersonal skills
Certifications
Registered Nurse (RN)Certified Case Manager (CCM)Certification in Developmental Disabilities Nursing (CDDN)
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