FEP Case Manager
BlueCross BlueShield of Tennessee
full-time
Posted on:
Location Type: Remote
Location: Tennessee • United States
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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
- 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 required.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
case managementutilization managementassessmentplanningimplementationcoordinatingmonitoringoutcomes evaluationclinical experienceIDD experience
Soft Skills
communication skillsinterpersonal skillstechnical support
Certifications
Registered Nurse (RN) license