Case Manager

🔥 7 hours ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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BlueCross BlueShield of Tennessee

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1952

🏥 Healthcare

💼 Consulting

🛡️ Insurance

Healthcare • Consulting • Insurance

BlueCross BlueShield of Tennessee is a leading health plan provider in Tennessee, serving 3. 4 million members. The company is committed to creating a workforce where everyone is valued, respected, and part of the team, emphasizing diversity and inclusion. They offer a range of career opportunities, including internships through their BlueBridge program, enabling new professionals to transition from college to work. BlueCross BlueShield of Tennessee also focuses on providing exceptional customer service and community care, striving to make a difference in the healthcare industry. It is an independent licensee of the Blue Cross Blue Shield Association and a qualified health plan issuer in the Health Insurance Marketplace.

📋 Description

• 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.

🎯 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. • The employee will also be required to adhere to the guidelines set forth through the program. • Business hours are 8-6 EST, with leadership working with each case manager to establish a schedule within these hours, allowing for adjustments to meet member needs. • Commitment to leveraging AI-enabled tools and technology to improve efficiency, streamline processes, and support continuous operational improvement.