Nurse Care Manager – Katie Beckett

🔥 13 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

• Manage a caseload of multiple complex pediatric member needs • Conduct member visits, including home visits, within contract timelines • Perform new member visits and ongoing assessments • Develop and maintain Person Centered Support Plans • Collaborate with private insurance and Medicaid to coordinate care and ensure appropriate coverage • Support utilization management functions for complex and non-routine cases • Serve as a liaison between members, providers, and internal/external customers • Oversee highly complex cases and implement interventions for efficient benefits utilization • Perform case management activities including assessment, planning, implementation, coordination, monitoring, outcomes, and evaluation • Provide effective communication via digital channels and technical support • Assess child development and milestones and provide resources for identified deficiencies • Identify goals and challenges through person- and family-centered planning • Identify needed home and community-based services • Coordinate additional Medicaid medical and behavioral health benefits

🎯 Requirements

• Pediatric experience • Strong communication and organizational skills • Attention to detail • Flexibility and adaptability • Willingness to travel for face-to-face meetings with members • Active Registered Nurse (RN) license in Tennessee, or a license in the state of residence if participating in the Nurse Licensure Compact • 3 years of clinical experience required • 5 years of experience in the health care industry • For Select Community & Katie Beckett: 2 years of experience in IDD required • Excellent oral and written communication skills • Basic Microsoft Office and email skills • Pediatric experience, preferably from an acute care setting • Clinical expertise caring for medically fragile children with complex medical and/or behavioral health needs • Ability to assess child development and milestones • Valid driver's license, compliant auto insurance, and acceptable motor vehicle record if routinely operating a vehicle for company business • Ability to complete a digital literacy assessment • 18-month commitment before posting for other internal positions

🏖️ Benefits

• Employee position • Various immunizations and/or associated medical tests may be required for this position