RN Field Case Manager
Sedgwick
Behavioral Health Case Manager
BlueCross BlueShield of Tennessee
full-time
Posted on:
Origin: • 🇺🇸 United States • Tennessee
Visit company websiteJob Level
Mid-LevelSenior
About the role
- The Behavioral Health Case Manager for Transitions of Care is dedicated to proactive engagement with members admitted to Acute Inpatient Psychiatric facilities.
- This role involves coordinating care to address immediate behavioral health needs and overcoming barriers to discharge from inpatient care.
- The goal is to reduce readmissions and adverse events through patient education, support, and connection to outpatient services.
- This hybrid position involves telephonic outreach and weekly visits to local Acute Inpatient Psychiatric facilities in the Murfreesboro area.
- The caseload is fluid, adapting to changes in facility admissions and referrals.
- Please note this role will require in person visits with members.
- In order to be considered, candidates must be willing to travel and will ideally be within 25 miles of Murfreesboro, Tennessee.
- 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. Perform case management activities in community settings including face to face with members as required. Various immunizations and/or associated medical tests may be required for this position. Testing/Assessments will be required for Digital positions
Requirements
- Current, active unrestricted Tennessee license in Nursing (RN) or behavioral health field (Master's level or above) required
- 3 years - Clinical behavioral health / substance use disorder experience required
- 1 year - Must be knowledgeable about community care resources and levels of behavioral health care available
- Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire
- Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
- Independent, Sound decision-making and problem-solving skills
- Excellent oral and written communication skills
- Strong interpersonal and organizational skills
- Strong analytical skills
- Positive relationship building skills and ability to engage and motivate health behaviors in diverse populations
- Ability to quickly identify and prioritize member needs and provide structured and focused support and interventions
- Experience with Motivational Interviewing Techniques and Adult Learning Styles
