Behavioral Health Intensive Care Management Coordinator

🕒 August 6

🌴 South Carolina – Remote

🌴 South Carolina – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 24%

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 identified with specific conditions • Assist with implementation of case management activities and health management programs for BCBSSC, BlueChoice, and/or Healthy Blue Medicaid members • Perform assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy for assigned members • Conduct required in-person member contacts and patient visits • Collaborate with members, families/caregivers, and healthcare professionals • 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 • Complete in-person assessments in members’ residences or least restrictive environments • Participate in meetings concerning members’ care • Use patient-information data systems and document information appropriately • Develop strategies to increase effectiveness and participation in health management programs • Establish and maintain communications with provider networks, group representatives, and members • Conduct monthly, quarterly, and annual report research and analysis • Adhere to NCQA requirements, state and federal regulations, and CMSA standards • Monitor member compliance and success rates • Identify needs for health management programs and monitor quality indicators • Develop patient and provider educational materials • Perform other duties as assigned

🎯 Requirements

• Four years of recent clinical experience in a defined Behavioral Health specialty area, or 4 years of Behavioral Health utilization review/case management/clinical/or combination experience, 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 a 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, make sound decisions, and exercise good judgment • Demonstrated customer service, organizational, and presentation skills • Demonstrated proficiency in spelling, punctuation, and grammar • 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 • Microsoft Office proficiency • If RN, active, unrestricted RN licensure from the United States and in the state of hire, or active compact multistate unrestricted RN license under the NLC • If LPN, active, unrestricted LPN licensure from the United States and in the state of hire, or active compact multistate unrestricted LPN license under the NLC • If Social Worker, active, unrestricted LBSW, LMSW, or LISW licensure from the United States and in the state of hire or with a state compact • For Mental Health Professionals, active, unrestricted LPC, LMFT, LAC, LPES, or Licensed Psychologist license from the United States and in the 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 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 • Diverse and inclusive workplace with opportunities to develop skills and advance careers • Reasonable accommodations for individuals with disabilities, pregnancy-related conditions, or sincerely held religious beliefs