Manages the coordination, training, development, and integration of clinical programs. Oversee staff responsible for the essential functions of case management.Job Description:Job Responsibilities
Monitoring productivity and performance based on departmental goals; identifying areas for quality improvement and ensuring updated processes are implemented.
Supervises, hires, motivates, and evaluates staff to assure effectiveness of programs and appropriate professional evaluation of clinical services.
Coordinates clinical interface with internal/external clients to ensure delivery of quality services.
Facilitates the implementation of programs, policies, and procedures related to clinical management programs.
Performing quality audits and review audit findings, providing feedback and training to staff as needed regarding clinical or technical information
Digital positions must have the ability to effectively communicate via digital channels and offer technical support; typing and grammar skills assessment is required for these positions, in addition to standard Windows 7 Testing.
Job QualificationsLicense
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
5 years - Experience in the healthcare industry or in an operations type environment required
3 years - Clinical experience required
2 years - Experience in a leadership/management role required
1 year - Utilization Management, or Case Management experience required
Various immunizations &/or associated medical tests may be required for this position.
For Select Community & Katie Beckett: 2 years experience in IDD is required
SkillsCertifications
Certified Case Manager (CCM) at hire, or obtained within 2 years.
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.
Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
Must be a team player, be organized and have the ability to handle multiple projects
Excellent oral and written communication skills
Strong interpersonal and organizational skills
Job Specific Requirements:Transplant and/or oncology experience preferredPreferred Skills:Number of Openings Available:1Worker Type:EmployeeCompany:BCBST BlueCross BlueShield of Tennessee, Inc.Applying for this job indicates your acknowledgement and understanding of the following statements:BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to 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 (https://www.bcbst.com/docs/equal-employment-opportunity.pdf)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.Tobacco-Free Hiring StatementTo further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test. An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotineand/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results.Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.About UsAs Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health for over 65 years. 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.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 applicant moves to Chattanooga, TN, they may be eligible for relocation benefits.