Blue Cross and Blue Shield of Illinois, Montana, N Case Management Coordinator II in Richardson, Texas
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
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BASIC FUNCTION:This position is responsible for performing concurrent review in accordance with accepted department criteria; performing discharge planning and identifying alternate treatment programs that provide medically necessary potentially cost effective services; consulting with physicians, providers, members, and other resources, as appropriate, to assess, plan, facilitate implementation, coordinate, monitor, and evaluate options and services required to meet an individual's health needs, using communication and available resources to promote quality, cost effective outcomes; serving as liaison to physicians, and members; serving as preceptor for less experienced staff.
JOB REQUIREMENTS:Register Nurse (RN) with current, valid, unrestricted license in state of operations or reciprocity.2 years of clinical experience of direct clinical care to the consumer.1 year experience in health insurance/managed care.Customer Service oriented. PC proficiency to include Word, Excel, Lotus Notes and database experience.Clear and concise verbal and written communication skills.
PREFERRED JOB REQUIREMENTS:3 years clinical experience. *Experience in Disease Management.Experience in managing complex or catastrophic cases.Working toward CM certification or Advanced degree.Knowledge of medical management policies and procedures.*Bilingual in Spanish/English.
Location: TX - Richardson
Activation Date: Tuesday, October 11, 2016
Expiration Date: Saturday, November 12, 2016