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**Are you driven by compassion and a commitment to supporting individuals with complex medical needs?** Join our team and help empower patients as they navigate the healthcare system and access the resources essential to their well\-being\.

As a **Complex Case Manager** , you will serve as a key coordinator for individuals facing multifaceted health and social challenges\. In this role, you will:

+ Assess patients’ physical, social, and financial needs

+ Develop and implement personalized care plans

+ Facilitate access to community resources and government programs

+ Navigate efficiently through NCQA audits

+ Collaborate with primary care providers and specialists to ensure seamless care coordination

You may also have the opportunity to support internal teams by maintaining continuity of care during staff absences \(FMLA, PTO\), becoming familiar with all cohort teams within the BlueCare Case Management division\. Prior experience **managing any projects requiring collaboration and high attention to detail** is a major plus\.

Our ideal candidates will also have at least **1 year of experience working with individuals with chronic illness** \(ex: sickle cell, brain injuries, oncology\-related needs\)\.

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 \(Basic Microsoft Office and E\-Mail\)

\- Qualified candidates must reside within 50 miles of the listed regional offices

\- Grade 10 BBEX Incentive Plan AEP

Number of Openings Available

1

Worker Type:

Employee

Company:

VSHP Volunteer State Health Plan, 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 \(https://www\.bcbst\.com/docs/equal\-employment\-opportunity\.pdf\)

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\.

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\.