RN Concierge Care Manager - Behavioral Health

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Position Overview

The job opening is for a RN Concierge Care Manager in the Behavioral Health department at BlueCross BlueShield of South Carolina. This position is full-time, requiring 40 hours a week, from 8:00 am to 5:00 pm EST, Monday to Friday, and will be fully remote. The successful candidate will be responsible for providing care management services to over 2 million members both in South Carolina and nationally, addressing a wide array of complex healthcare needs.

Key Responsibilities

The Concierge Care Manager will:

• Direct day-to-day management for members, ensuring coordination of treatment plans for high-risk patient populations.

• Work closely with external sources, including healthcare providers, vendors, and community services, to facilitate care.

• Implement program goals along with quality assurance efforts, and prepare for audits related to care services.

• Additionally, contribute to team training and continuing medical education initiatives.

Required Qualifications

To qualify for this position, candidates must meet the following requirements:

• Graduation from an Accredited School of Nursing or a degree in nursing.

• Possession of a Master's degree in Social Work, Psychology, or Counseling.

• A minimum of 5 years case management experience as a registered nurse, or 2 years of experience in a health insurance environment.

• Proficient knowledge of Microsoft Office and other software relevant to case management.

Preferred Skills

The employer prefers candidates who possess:

• A Bachelor's degree in a health-related field like Nursing, Healthcare Administration, or Pharmacy.

• Extensive case management experience, particularly in sub-specialties, including ICU, Palliative Care, Hospice, or Home Health settings.

• Strong communication and customer service skills paired with excellent analytical abilities.

• Familiarity with software like TMCS, LiveOps, and BlueVue is also a plus.

Required Licenses and Certifications

Candidates must have:

• An active, unrestricted RN licensure in the United States.

• A nationally recognized Case Management certification which must be obtained within two years of hiring as a Case Manager.

Work Environment and Expectations

As a part of BlueCross BlueShield, employees can expect a supportive and diverse team environment, with ample opportunities for professional development and continuing education.

This role demands individuals who can effectively work independently, manage priorities , and make decisions based on analytical skills. Customer service experience is crucial, alongside a proven track record in organizational and presentation skills.

Salary and Benefits

While the job description does not include a specific salary range, BlueCross BlueShield offers comprehensive benefits, which may include:

• A 401(k) retirement savings plan with company match.

• Subsidized health plans along with complimentary vision coverage.

• Life insurance and paid annual leave, which increases with tenure.

• Nine paid holidays, and wellness programs that encourage healthy lifestyles.

• Tuition assistance and support for continuing education, enabling employees to enhance their qualifications and maintain required certifications.

• Participation in incentive plans that are aligned with employee performance and contribution to team objectives.

Recruitment Process

After submitting an application, candidates will undergo a review process. This may include initial communication via telephone or email with a recruiter to verify qualifications and salary expectations. Qualified applicants will be invited for interviews with management, prioritizing individuals with a background in case management to ensure robust experience in the healthcare domain.

BlueCross BlueShield is an Equal Opportunity Employer, committed to maintaining a non-discrimination policy in hiring practices, which promotes opportunities for individuals regardless of various identity factors. The organization also participates in E-Verify.

Conclusion

This opportunity represents an exciting chance for Registered Nurses or professionals in behavioral health to make a significant impact by managing care for individuals facing complex health challenges. The role allows for both personal growth and the chance to contribute meaningfully to the well-being of a diverse membership base.

This job offer was originally published on himalayas.app