BH Case Manager – Federal Employee Program

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🎸 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 Insurance

Healthcare 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. • Perform case management activities in community settings including face to face with members as required.

🎯 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. • Experience with Motivational Interviewing Techniques and Adult Learning Styles. • Currently has a Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire. • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint).

🏖️ Benefits

• Remote work policy • Flexible work arrangements • Comprehensive care management