BH Case Manager- ICF

Our BlueCare team at BCBST is looking to hire a Behavioral Health Case Manager to support members within the Intellectual and Developmental Disability (IDD) population to join their team!

In this role, you will work collaboratively as part of a specialized team focused on ICF/IID support and build ongoing, trusted relationships with members, their caregivers, and providers to ensure effective care coordination and strong member advocacy. Services include a hybrid of remote and member visits at the ICF provider homes, supporting members specifically in the Northeast region the state of Tennessee. You will also manage a set caseload of long-term members to address ongoing care coordination needs.

To be successful in this role, in addition to meeting the core job requirements, you will bring prior case management or care coordination experience, with experience supporting the IDD population strongly preferred. You are open to learning and able to be trained to support IDD members if your direct experience is limited, and you are comfortable managing a consistent caseload with diverse and complex needs. Strong organizational skills and the ability to work independently in a fully remote environment are essential for success in this role.

Additional Notes

• Candidates will need to reside in the state of Tennessee.
• This is a hybrid role, that will require member visits to ICF provider homes.
• Sponsorship is not available for this position.
• At BCBST, we foster a culture where innovation is encouraged, including the responsible use of AI-enabled tools to support everyday work. As roles become more advanced, employees are expected to leverage AI, guided by established workflows, templates, and policies, to improve how we serve our members

Job Responsibilities

• 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.
• Various immunizations and/or associated medical tests may be required for this position.
• Testing/Assessments will be required for Digital positions.

Job Qualifications

License

• Current, active unrestricted Tennessee license in Nursing (RN) or behavioral health field (Master’s level or above) (Ph.D., LCSW/LMSW, LLP, MHC, LPC, etc.) required. RN may hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.

Experience

• 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.

Skills\Certifications

• Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
• Independent, Sound decision-making and problem-solving skills
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills
• Strong analytical skills
• Positive relationship building skills and ability to engage and motivate health behaviors in diverse populations
• Ability to quickly identify and prioritize member needs and provide structured and focused support and interventions
• Experience with Motivational Interviewing Techniques and Adult Learning Styles

Number of Openings Available

1

Worker Type:

Employee

Company:

VSHP Volunteer State Health Plan, Inc

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST’s EEO Policies/Notices may be found by reviewing the following page:

BCBST’s EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.