What are the responsibilities and job description for the ACHN RN Care Manager position at Blue Cross and Blue Shield of Alabama?
Overview
Department Overview
Our subsidiary is responsible for coordinating care for healthy eligible individuals, those with multiple chronic conditions, pregnant women, and men and women needing family planning. The goal of the program is to ensure an effective and efficient delivery of care. This area works with low income populations to improve the quality of care programs and community outreach.
Primary Responsibilities
This position performs care management for recipients assigned by the State of Alabama Medicaid Office. Our subsidiary provides this care management for recipients enrolled in programs designated by State of Alabama Medicaid. Performance guidelines are in place to ensure that sound care plans are developed and acted upon in a timely manner so as to improve the recipient’s overall health. This care management frequently involves face-to-face meetings with the recipients to gain a full understanding of their challenges. This position will primarily provide services to home care and community based populations, identified as needing care management and transitional services from inpatient facilities.
Summary Of Qualifications
By submitting a job application, I attest that all information to the best of my knowledge is true and accurate. Furthermore, I understand that any information provided by me throughout the job application process is subject to verification including, but not limited to work experience, education, assessment (test) and interviews.
We appreciate your interest in “The Company. The Company does not discriminate in hiring or employment on the basis of race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetics, status as a disabled or protected veteran, or because of citizenship status in the case of a citizen or intending citizen. No question on this application is intended to secure information to be used for such discrimination.
Department Overview
Our subsidiary is responsible for coordinating care for healthy eligible individuals, those with multiple chronic conditions, pregnant women, and men and women needing family planning. The goal of the program is to ensure an effective and efficient delivery of care. This area works with low income populations to improve the quality of care programs and community outreach.
Primary Responsibilities
This position performs care management for recipients assigned by the State of Alabama Medicaid Office. Our subsidiary provides this care management for recipients enrolled in programs designated by State of Alabama Medicaid. Performance guidelines are in place to ensure that sound care plans are developed and acted upon in a timely manner so as to improve the recipient’s overall health. This care management frequently involves face-to-face meetings with the recipients to gain a full understanding of their challenges. This position will primarily provide services to home care and community based populations, identified as needing care management and transitional services from inpatient facilities.
Summary Of Qualifications
- Bachelors of Science in Nursing or Associate Degree or Diploma in Nursing
- Must have two (2) years of recent experience working in a clinic setting or combined hospital experience; and
- Minimum on one (1) year experience in care coordination/case management working with low-income and diverse populations; must include experience working with individuals in Medicaid populations receiving care coordination/case management services.
- Active Alabama license in good standing as a Registered Nurse (RN)
- Must live and work within the region or adjoining county
- Have strong verbal and written communication skills to encourage and engage recipients in plan of care
- Ability to sufficiently document electronic case records including writing effective care plans and SMART goals
- Ability to manage a heavy caseload
- Experience analyzing clinical situations and making informed decisions
- Experience in a position demonstrating exceptional written, verbal and interpersonal communications
- Experience in a position exercising independent judgement and decision making
- Experience in a position working with medical providers and/or community resource agencies
- Willingness to travel as required for the job
- Two years of complex pediatric experience preferred
- Experience working in a home setting as a Case Manager or Care Coordinator preferred
- Knowledge of Alabama Medicaid regulations and guidelines preferred
- Knowledge of community based agencies and resources is preferred preferred
- Experience working in a behavioral health hospital or residential facility preferred
By submitting a job application, I attest that all information to the best of my knowledge is true and accurate. Furthermore, I understand that any information provided by me throughout the job application process is subject to verification including, but not limited to work experience, education, assessment (test) and interviews.
We appreciate your interest in “The Company. The Company does not discriminate in hiring or employment on the basis of race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetics, status as a disabled or protected veteran, or because of citizenship status in the case of a citizen or intending citizen. No question on this application is intended to secure information to be used for such discrimination.