Job Description

BlueCross BlueShield of Tennessee \(BCBST\) is seeking a skilled and compassionate Registered Nurse to join our fast\-paced, high\-performing team\. In this Medical Case Manager role, you will work exclusively on a single large group account, partnering with members and their providers to deliver timely, coordinated, and effective care for a variety of health conditions\. Our ideal candidates will be energized by engaging and connecting with members over the phone and through digital channels\. They will find fulfillment in supporting our members through clear communication and proactive problem\-solving\. Whether it's guiding someone through a complex issue or simply offering a reassuring voice, our team members excel at making meaningful connections and delivering exceptional service with every interaction\. To thrive on this fully remote team, you'll need to be tech\-savvy, adaptable, and experienced in managing complex patient needs across a wide range of medical conditions\. A well\-rounded clinical background and experience supporting patients through transitions of care are essential for success in 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_ + Currently has a Certified Case Manager \(CCM\) credential or must obtain certification within 2 years of hire\. + For Select Community & Katie Beckett: In addition to CCM, Certification in Developmental Disabilities Nursing \(CDDN\) is required at hire, or must be attained within 3 years\. + Excellent oral and written communication skills + PC Skills required \(Basic Microsoft Office and E\-Mail\) Employees who are required to operate either a BCBST\-owned vehicle or a personal or rental vehicle for company business on a routine basis\* will be automatically enrolled into the BCBST Driver Safety Program\. The employee will also be required to adhere to the guidelines set forth through the program\. This includes, maintaining a valid driver's license, auto insurance compliance with minimum liability requirements; as defined in the "Use of Non BCBST\-Owned Vehicle" Policy \(for employees driving personal or rental vehicles only\); and maintaining an acceptable motor vehicle record \(MVR\)\.\*The definition for "routine basis" is defined as daily, weekly or at regularly schedule times\. **Number of Openings Available** 1 **Worker Type:** Employee **Company:** BCBST BlueCross BlueShield of Tennessee, 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\.** As Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health since 1945\. More than that, we're your neighbors and friends - fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow\. At BCBST, we empower our employees to thrive both independently and collaboratively, creating a collective impact on the lives of our members\. We seek talented individuals who excel in a team environment, share responsibility, and embrace accountability\. We're also seeking candidates who are proficient in the Microsoft Office suite, including Microsoft Teams, organized, and capable of managing multiple assignments or projects simultaneously\. Additional, strong interpersonal abilities along with strong oral and written communication skills are important across all roles at BCBST\. BCBST is a remote\-first organization with many employees working primarily from their homes\. Each position within the company is classified as either fully remote, partially remote, or office based\. BCBST hires employees for remote positions from across the U\.S\. with the exception of the following states: California, Massachusetts, New Hampshire, New Jersey, and New York\. Applicants living in these states may move to an approved state prior to starting a position with BCBST at their own expense\.If the position requires the individual to reside in Chattanooga, TN, they may be eligible for relocation assistance\.

Job Tags

Work at office, Remote work, Relocation package,

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