Intensive Care Management Coordinator

Overview

We are currently hiring for an Intensive Care Management Coordinator to join Blue Cross Blue Shield of South Carolina. In this role you will serve as an Intensive Case Manager (ICM) for members identified with specific conditions and assist with implementation of case management activities/programs for Blue Cross Blue Shield of South Carolina (BCBSSC), Blue Choice and/or Healthy Blue Medicaid members.

This position is full-time (40 hours/week) Monday-Friday from 8:30am-5:00pm EST and will be fully remote. This position will require the candidate to spend most of their time traveling within a South Carolina region to conduct member-facing patient visits. This position offers mileage reimbursement after mile 50 with a reimbursement rate of 70 cents per mile, and a travel limit of 3-hours one way.

Our ideal candidate must reside in the Pee Dee or Low-Country Regions of South Carolina.

• Perform primary functions of assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy of assigned members. In-person contact with the member is required. Collaborate and communicate with the member, member's family/caregiver and other healthcare professionals involved in the member's care. Ensure care coordination and case management activities are aligned with members' risk levels and identified strengths, preferences, needs and desired outcomes. Assist with implementation of health management activities/programs for membership.
  
  Coordinate all aspects of assigned programs. Follow and assist with updates to updates of established procedures. Complete in-person assessments in the member's residence or least restrictive environment. Participate in meetings concerning the member's care. Utilize all data systems containing patient information and documents information appropriately.
• Assist with development of strategies to increase effectiveness of and participation in health management programs. Establish and maintain effective communications with provider network, group representatives and members.
• Conduct research and analysis of reports (monthly, quarterly, annually). Adhere to NCQA requirements, state/federal regulations and CMSA standards. Monitor member compliance and success rate.
• Assist with identification of areas for which there is a need for health management programs. Monitor quality indicators and identify programs to positively impact areas where improvement is warranted. Develop patient/provider educational materials for members/providers. Perform other duties as assigned.

• Required
  
  Education:
  
  Bachelor’s degree from an accredited university or college in Nursing, Health Administration, Health Promotion, Exercise Science, Education/Training, Social Work, or health-related field with a minimum of 45 documented training hours related to specialty area issues and treatment.
• Degree Equivalency: If Behavioral Health Intensive Case Manager: 4-year degree in nursing, psychology, social work, early childhood education, child development or a related field with minimum of 45 documented training hours related to specialty area issues and treatment.
• If Maternal Health Intensive Case Manager: 4-year degree in Health Promotion or related field OR 2-year degree and 2 years' experience in healthcare environment or as a Certified Childbirth Educator/Prenatal Educator, OR graduate of an approved LPN program and 2 years' experience in maternity management healthcare environment.
• If Medical Health Intensive Case Manager: 4-year degree in Health Promotion, Exercise Science, or related field or Certified Asthma Educator or RRT (Registered Respiratory Therapist).
• If Master’s, 1 year experience may also be in Exercise Science, Nutrition, Physical Therapy, or other health-related degrees. If Wellness Coach/Health Promotion: 4-year degree in Health Administration, Health Promotion, Exercise Science, Education/Training, or health-related field.
• Required
  
  Work Experience:
  
  At least 3 years' experience working with people with specified health conditions.
• If master's degree, 2 years' experience working with people with specified health…