What are the responsibilities and job description for the RN Care Coordinator position at Blue Cross Blue Shield of Alabama?
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.
This position performs care management for eligible individuals (EIs) assigned by the State of Alabama Medicaid Office. Our subsidiary provides this care management for EIs 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 EIs overall health. This care management frequently involves face-to-face meetings with the EIs 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.
This is a field based position with required daily travel in the Central region of the Alabama Coordinated Health Network (ACHN). The incumbent will support members in their local area. The Central Region includes the following counties: Chilton, Perry, Marengo, Wilcox, Dallas, Autauga, Elmore, Lowndes, Montgomery, Butler and Crenshaw counties. The incumbent should live within or in close proximity to the counties outlined in the coverage area.
- Bachelor of Science in Nursing or Associate Degree or Diploma in Nursing
- Active Alabama license in good standing as a Registered Nurse (RN)
- 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 is preferred
- Experience working in a behavioral health hospital or residential facility is preferred
- Experience working in a home setting as a Case Manager or Care Coordinator is preferred
- Knowledge of Alabama Medicaid regulations and guidelines is preferred
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