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FEP Medical Case Manager

3 months ago

Iowa City, Iowa, United States BCBST BlueCross BlueShield of Tennessee, Inc. Full time

BlueCross BlueShield of Tennessee, Inc.

Job Description

  • Supporting utilization management functions for complex and non-routine cases as needed.
  • Serving as a liaison between members, providers, and internal/external customers for health care delivery and benefits programs.
  • Overseeing highly complex cases to ensure effective interventions and benefits utilization.
  • Performing essential case management activities like assessment, planning, implementation, and monitoring.
  • Digital positions require effective communication through digital channels and technical support skills.
  • Completion of an 18-month commitment before applying for other internal positions.

Job Requirements

  • Active RN license in Tennessee or the state of residence if part of the Nurse Licensure Compact Law.
  • 3 years of clinical experience and 5 years in the healthcare industry.
  • Various immunizations and medical tests may be needed.
  • 2 years experience in IDD for specific communities.
  • Possession of CCM credential or obtaining certification within 2 years of hire date.
  • Certification in CDDN within 3 years for specific communities.
  • Strong oral and written communication skills.
  • PC Skills required, including Microsoft Office and Email proficiency.

Preferred Skills:

Number of Openings Available:

1

Worker Type:

Employee

BlueCross BlueShield of Tennessee is an Equal Opportunity Employer

BlueCross BlueShield of Tennessee promotes equal employment opportunities without bias. They support recruitment, hiring, and promotion regardless of race, religion, age, sex, or any other characteristic protected by law.

Tobacco-Free Hiring Statement

BlueCross BlueShield of Tennessee and its subsidiaries have a tobacco-free hiring policy since 2017. They do not hire individuals who use tobacco or nicotine products in any form, encouraging health and wellness for employees and the community. Employment offers are contingent on passing background checks that include illegal drug and tobacco/nicotine testing.

Resources for quitting tobacco/nicotine products are available at 1-800-QUIT-NOW.