The Volunteer State Health Plan, Inc. (VSHP) CHOICES program offers person-centered care planning, service coordination, and support services for members receiving long-term care and/or home and community based services. The ancillary care coordinator works alongside HCBS, discharge, and institutional care coordinators to promote interdependent collaboration with the member, physician/primary care manager, family, and other members of the care coordination team. To accomplish this collaboration, the ancillary care coordinator will assist the care coordination team by conducting telephonic contacts with members to ensure continuity of care and performing additional activities as needed to support HCBS, discharge, institutional and care coordinators. Positions are available at VSHP offices located in Nashville, TN.
Job Duties & Responsibilities
Conduct interim monthly telephonic contacts with members to monitor status, needs and progress, as needed by the care coordination team.
Upon direct provider referral, conduct telephonic screenings with VSHP members to determine if they may need and qualify for the CHOICES program.
Receive incoming calls from members and assist in resolving problems, issues and concerns. Alert assigned HCBS care coordinator of issues and outcome.
Enter documentation of contacts with members into the care coordination system.
Provide assistance to HCBS, discharge, and institutional care coordinators in resolving concerns about service delivery or providers.
Issue authorizations for services.
Arrange services on plans of care for members.
Establish working relations with referral sources, community resources, and care providers.
Conducts disease management interventions with applicable members.
Other duties deemed necessary for efficient and effective unit operations.
Registered nurse or Licensed Practical Nurse with an active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Act;, MSW or BSW
Minimum 3 years varied clinical experience required.
Minimum 2 years experience providing care coordination support to persons receiving long-term care and/or home and community based services and an additional year of work experience in managed and/or long-term care setting highly preferred.
Exceptional skills of independence, organization, communication, problem-solving, professional interaction, and human relation skills, as well as analytical skills required.
Ability to work within specified timeframe requirements
Must be able to handle interruptions, set priorities and adapt to change
Must be well organized and have experience in managing multiple assignments with critical deadlines
Excellent communications skills (both verbal and written)
Proficient knowledge of PC and Microsoft Office
BlueCross BlueShield of Tennessee (BCBST) is the oldest and largest not-for-profit managed care provider in the state of Tennessee....