We are hiring a Home Health Case Manager at BCBST!
In this role, you will support TennCare (Medicaid) members with complex medical, functional and social needs. You will coordinate home and community-based care, conduct required home visits, and support members transitioning to adult benefits. You’ll collaborate closely with providers and internal care teams using digital tools to identify care gaps, reduce hospitalization risk, and improve outcomes.
To be successful in this role, in addition to the core job requirements, you'll bring strong clinical judgement, experience using digital tools to communication, and availability for home visits. You will be a strong candidate for this role if you have the following: home health or hospice nursing experience, pediatric experience, knowledge of MTLSS programs, and familiarity with community-based services.
Note:
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This is a remote, Monday-Friday (8:00 a.m.-5:00 p.m.) role with flexibility to support member needs, however this role requires traveling to members' homes in the Memphis area and surrounding counties.
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Candidates must live within 50 miles of Memphis.
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Sponsorship is not available for this role
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.
- Digital positions must have the ability to effectively communicate via digital channels and offer technical support.
- Effective 7/22/13: This Position requires an 18 month commitment before posting for other internal positions.
- Various immunizations and/or associated medical tests may be required for this position.
- This job requires digital literacy assessment.
Job Qualifications
License
- Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.
Experience
- 3 years – Clinical experience required
- 5 years – Experience in the health care industry
- For Select Community & Katie Beckett: 2 years experience in IDD for Select Community is required
Skills\Certifications
- Excellent oral and written communication skills
- PC Skills required (Basic Microsoft Office and E-Mail)
Grade 07 BBNEIncentive Plan AEP
Preference will be given to candidates in cost center 338
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:
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.
Additional Information
Company: BlueCross BlueShield of Tennessee
Location: Tennessee
Salary:
Job ID: R-50946
Specialties: Case Manager
Required Licenses: RN
Experience Level: 1-3 years
