RN Case Manager
关于明尼苏达州蓝十字和蓝盾的蓝十字，我们致力于为每个人都实现最健康的生活铺平道路。我们正在寻找志愿者和有动机的人士，他们分享我们的医疗保健转型视野。作为蓝十字会员，你加入了一个基于共同成功，找到更好的方法和做正确的事情的文化。如果你准备好改变，请加入我们。你将会产生影响通过进行评估，识别护理差距并制定个性化的护理计划提供电话支持对行为健康需求的成员。这一角色协调推，将成员联系到社区和网络提供商，并帮助成员了解他们的好处，确保无需直接临床护理的全面支持。你会做什么 · 仅通过电话进行参与，使用动机采访和治疗技术鼓励参与。管理新病例和后续呼叫，确保及时有效的支持。·制定和监测个性化护理计划，设定后续行动和目标。·导航多种系统收集相关信息和更新案例文档。如何做到这一点 · 审查成员信息，并为开展临床评估和记录发现的宣传调用做准备。· 研究，提交推和与提供商协调，以将会员联系到适当资源和服务，进行后续工作，确保接收和跟进。· 参加临床轮回和团队会议来审查案件，获得反，并确保最佳实践。· 在客户或供应商审计期间，为客户或经销商审核而筹备和提出案例，捍卫所采取行动以及响应查询。· 通过与会员服务合作解决问题，同时持续支持成员。· 咨询团队成员确保最佳实践，参与必要的培训和协助专业项目；经常指导并为新聘者提供影机会。· 根据职位范围和水平履行额外责任。所需技能和经验 · 3年以上相关案例管理 （临床）的专业经验。· 本科学位；取代学位，另外两年相关经验 b
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About Blue Cross and Blue Shield of Minnesota
At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.
The Impact You'll Have
Provides telephonic support to members with behavioral health needs by conducting assessments, identifying gaps in care, and developing individualized care plans. This role coordinates referrals, connects members to community and in-network providers, and helps members understand their benefits, ensuring comprehensive support without delivering direct clinical care.What You'll Do
- Provide telephonic engagement only, using motivational interviewing and therapeutic techniques to encourage participation. Manage a mix of new cases and follow-up calls, ensuring timely and effective support.
- Develop and monitor individualized care plans, setting follow-up actions and goals.
- Navigate multiple systems to gather relevant information and update case documentation.
How You'll Do It
- Review member information and prepare for outreach calls to conduct clinical assessments and document findings.
- Research, place referrals and coordinate with providers to connect members to appropriate resources and services, following up to ensure receipt and follow through.
- Participate in clinical rounds and team meetings to review cases, receive feedback, and ensure best practices.
- Prepare for and present cases during client or vendor audits, defending actions taken and responding to inquiries
- Navigate complex member situations, including privacy issues due to family dynamics, by collaborating with Member Services to resolve concerns while maintaining ongoing support for the member.
- Consult with team members to ensure best practices, participate in required training, and assist with specialty projects; frequently mentor and provide shadowing opportunities for new hires.
- Performs additional responsibilities consistent with the scope and level of the role, as assigned.
Required Skills & Experience
- 3+ years of related case management (clinical) professional experience.
- Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted. Flexibility to work varied hours.
Preferred Skills & Experience
- Ability to tailor communication to varied audiences, actively listen to uncover requirements, and ensure accurate and timely information exchange.
- Ability to analyze information, identify patterns and root causes, and collaborate with partners to implement practical solutions.
- Ability to leverage technology to tailor communications to varied audiences, listen to uncover needs, analyze root causes, and collaborate on practical solutions.
- Ability to effectively organize work, balance competing priorities, and manage time across multiple responsibilities and deadlines.
Licensure/Certifications
Required:
Registered Nurse (RN) - State Nursing Licensing Board
Temporary Registered Nurse (RN) - State Nursing Licensing BoardRole Designation
TeleworkerRole designation definition:
- Teleworking is working full time remote.
- Hybrid is a minimum of 2 days onsite.
- Onsite is full-time onsite.
Compensation and Benefits
$68,900.00 - $91,300.00 - $113,700.00 AnnualPay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.
We offer a comprehensive benefits package which may include:
- Medical, dental, and vision insurance
- Life insurance
- 401k
- Paid Time Off (PTO)
- Volunteer Paid Time Off (VPTO)
- And more
To discover more about what we have to offer, please review our benefits page.
Equal Employment Opportunity Statement
At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.
Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: .
Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
Physical requirements.
Originally posted on Himalayas