Behavioral Health Intensive Care Management Coordinator

🕒 August 6

🌴 South Carolina – Remote

🌴 South Carolina – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 62%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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BlueCross BlueShield of South Carolina

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1946

🏥 Healthcare

💼 Consulting

⚖️ Legal

Healthcare • Consulting • Legal

BlueCross BlueShield of South Carolina is a leading health insurance provider that offers a variety of health plans, including individual and family plans, Medicare options, and group health plans. The organization focuses on providing coverage and resources for members, employers, and healthcare providers, ensuring access to quality healthcare services. With a commitment to promoting healthier lifestyles and supporting community health, BlueCross BlueShield of South Carolina plays a vital role in the healthcare landscape of the region.

📋 Description

• Serve as an Intensive Case Manager for members with specific conditions • Assist with implementation of case management and health management activities/programs for BCBSSC, BlueChoice, and/or Healthy Blue Medicaid members • Assess, plan, facilitate, coordinate, monitor, evaluate, and advocate for assigned members • Conduct required in-person member visits and assessments in members’ residences or least restrictive environments • Collaborate with members, families/caregivers, healthcare professionals, providers, group representatives, and internal stakeholders • Align care coordination and case management activities with members’ risk levels, strengths, preferences, needs, and desired outcomes • Coordinate all aspects of assigned programs and follow established procedures • Use patient-information data systems and document information appropriately • Develop strategies to increase effectiveness and participation in health management programs • Conduct monthly, quarterly, and annual report research and analysis • Adhere to NCQA requirements, state and federal regulations, and CMSA standards • Monitor member compliance, success rates, and quality indicators • Identify needs for health management programs and develop programs to improve warranted areas • Develop patient and provider educational materials • Participate in meetings concerning member care • Perform other duties as assigned

🎯 Requirements

• At least two years of recent clinical experience in a defined Behavioral Health specialty area; alternatively, 4 years of Behavioral Health utilization review/case management/clinical/or combination, with 2 of the 4 years clinical • Bachelor's degree from an accredited university or college in Nursing, Health Administration, Health Promotion, Exercise Science, Education/Training, Social Work, or a health-related field, with a minimum of 45 documented training hours related to specialty area issues and treatment • For Behavioral Health Intensive Case Manager: 4-year degree in nursing, psychology, social work, early childhood education, child development, or a related field, with minimum of 45 documented training hours related to specialty area issues and treatment • At least 3 years’ experience working with people with specified health conditions; if master’s degree, 2 years’ experience • Working knowledge of word processing, spreadsheet, database, and presentation software • Understanding of insurance and benefit programs as related to health management coverage • Knowledge of the quality improvement process • Ability to work independently, prioritize effectively, and make sound decisions • Customer service, organizational, presentation, spelling, punctuation, and grammar skills • Ability to persuade, negotiate, or influence others • Analytical or critical thinking skills • Ability to handle confidential or sensitive information with discretion • Ability to drive and be available on nights and weekends • Familiarity with evidence-based assessments • Knowledge of national case management standards • Proficiency with Microsoft Office • If RN, active unrestricted RN licensure from the United States and state of hire, or active compact multistate unrestricted RN license • If LPN, active unrestricted LPN licensure from the United States and state of hire, or active compact multistate unrestricted LPN license • If Social Worker, active unrestricted LBSW, LMSW, or LISW licensure from the United States and state of hire or with a state compact • For Mental Health Professionals, active unrestricted LPC, LMFT, LAC, LPES, or Licensed Psychologist licensure from the United States and state of hire or with a state compact • Experience working directly with individuals with mental illnesses preferred • Must reside in the Low-Country Region of South Carolina, preferably Charleston or Beaufort County

🏖️ Benefits

• Subsidized health plans, dental and vision coverage • 401k retirement savings plan with company match • Life Insurance • Paid Time Off (PTO) • On-site cafeterias and fitness centers in major locations • Education Assistance • Service Recognition • National discounts to movies, theaters, zoos, theme parks and more • Mileage reimbursement after mile 50 at a reimbursement rate of 70 cents per mile