CHOICES Associate Care Coordinator - Nashville
BlueCross BlueShield of Tennessee - Nashville, TN

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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.

Qualifications

Education

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

Experience

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.

Skills/Certifications

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 - 21 months ago - save job - block
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BlueCross BlueShield of Tennessee (BCBST) is the oldest and largest not-for-profit managed care provider in the state of Tennessee....