Are you looking for a fulfilling position where you don't have to:
Worry about billable hours
Work nights and weekends
Be on-call
And where you do have:
Work/life balance
Paid Time Off, including Floating Holiday and Self-Care Day
Hybrid work schedule
License renewal reimbursement
Supportive team and leadership
Then consider applying to be a Clinical Care Coordinator at Blue Cross of Idaho. Clinical Care Coordinators are health care advocates creating connections, motivating healthy decisions, and helping Idahoans receive the care they deserve!
Clinical Care Coordinator delivers care coordination for our members using a collaborative process. In this role, you will build relationships and engage with members both in person and telephonically. Assess, plan, implement, monitor, and evaluate member needs to ensure quality, cost effective outcomes. This position will serve members residing in Northern Idaho and will work from our Idaho Falls, Idaho location (hybrid opportunity).
To be considered for this opportunity you have:
Experience: 3 years' relevant experience
Education: Associate degree in Nursing or Bachelor's Degree in Social Work; or equivalent work experience (Two years' relevant work experience is equivalent to one-year college)
Other: Travel Required up to 50%; Valid State of Residence Driver's License & Automobile Liability Insurance
To be successful in this position, you have the following knowledge, skills, and abilities:
Knowledge of:
Community agencies and resources
Multi-system outreach programs related to health care delivery, clinical education, and health-related services
Case management and/or utilization management standards
Quality metrics and data points
Medicare/Medicaid regulations
Skills:
Strong interpersonal and communication
Strong problem-solving capability
Strong written and verbal communication
Attention to detail and accuracy
Continuous process improvement
Motivational Interviewing
Microsoft Excel - Intermediate
Microsoft Word - Intermediate
High degree of initiative and team player
Ability to:
Work effectively with a wide range of populations in a diverse community
Travel to on-site locations to facilitate community-based interactions with member
Be an advocate for and support, encourage and motivate members.
Maintain positive working relationships with members, families, providers, and other external customers
Build trust, actively listen, intentionally communicate, collaborate and problem solve
Influence others toward positive outcomes
Evaluate individual member care needs and communicate medical information to health care professionals
Work in a multicultural setting
Demonstrate passion for helping people improve their lives
We'd also love it if you had:
Bachelor's Degree in Nursing
Managed care experience
Healthcare Insurance Industry Experience
In this role, we will ask you to:
Conduct outreach to motivate, facilitate, and educate members about the benefits of programs.
Conduct assessments of the members' status and develops a care plan with the member to address member's goals. Assessments are conducted both in person in a member's usual care setting, by telephone, or using video conferencing.
Identify, plan, implement, and evaluate appropriate health care interventions in conjunction with the provider.
Facilitate coordination of care with providers. Motivate members to be active and engaged participants in their health and overall well-being.
Help members review benefit concerns and connects with internal resources to expedite resolution of concerns and inquiries.
Support special programs within the department.
Provide administrative support to internal and external care management and care coordination teams.
Coordinate and complete correspondence according to established workflows.
May coordinate and lead weekly interdisciplinary care team meetings with internal and external participants.
May coordinate and lead clinical specialty consultation team meetings with internal teams.
May provide guidance and direction for other Care Coordination staff in accordance with regulatory and/or business requirements.
Reasonable accommodations
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
