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Case Manager
5 months ago
Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We're committed to reinventing health care to improve health for our members and the community. We hope you'll join us.
How Is This Role Important to Our Work?
The Case Manager is a critical component of BCBSMN Care Management team as the primary clinician providing condition and case management services to members. The position exists to support member needs across the continuum of care by leveraging member partnership, case and disease management processes, skill sets and tools.
A Day in the Life:- Receives referral and/or reaches-out to member and leverages clinical knowledge, motivational interviewing and behavioral modification techniques.
- Conducts comprehensive clinical assessments; gathers, analyzes, synthesizes and prioritizes member needs and opportunities.
- Collaborates and communicates with member, family, or designated representative on a plan of care that produces positive clinical results and promotes high-quality effective outcomes.
- Identifies relevant BCBSMN and community resources and facilitates warm program and network referrals.
- Monitors and evaluates plan of care over time.
- Ensures member data is documented according to BCBSMN application protocol and regulatory standards.
- Maintains outstanding level of service at all points of customer contact.
- Understands broad-based goals of assigned market segment(s) including clinical and service availability.
- Collaborates and coordinates with team members to facilitate day to day functions and enhance the overall operation of the department.
- Engage providers telephonically in reviewing and understanding treatment plans, including alignment with benefits and medical reimbursement policies to facilitate optimal treatment plans, care coordination, and transition of care between settings.
Required Skills and Experiences:
- Registered Nurse with Psychiatric experience or Behavioral Health Professional that is Clinician licensed for independent practice with one or more of the following licenses with no restrictions:- Licensed Marriage and Family Practice (LMFT)- Licensed Independent Clinical Social Worker (LICSW)- Licensed Psychologist (LP)- Licensed Professional Counselor (LPC)- Licensed Professional Clinical Counselor (LPCC)
- 3 years relevant direct clinical care experience.
- All relevant experience including work, education, transferable skills, and military experience will be considered.
- CCM Certification or ability to obtain within 3 years of starting in the position.
- Excellent communication skills.
- Excellent conceptual thinking skills.
- Excellent relationship management skills.
- Excellent organizational skills.
- Computer application proficiency.
- Flexibility to work varied hours.
- 1+ years of managed care experience; e.g.case management/health coach, utilization management and/or auditing experience.
- Outstanding telephonic skills.
Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.
Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com.
All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.
Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
Blue Cross and Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.
