Case Manager

Join Blue Cross of Idaho's growing Healthcare Operations team! In this role, care managers will effectively care-manage members utilizing a collaborative process. Work independently and under limited supervision. Assess, plan, implement, monitor, and evaluate the options and services required to meet an individual’s health needs using communication and available resources to promote quality, cost-effective outcomes.

What We Are Looking For In Care Manager

Experience: 3 years’ relevant experience

Education: Associates 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)

Licenses/Certifications: Must hold one of the following:

• Valid unrestricted Idaho Registered Nurse License
• Valid unrestricted Idaho Social Worker License
  
  

What Your Day May Look Like

• Conducts an evaluation of the members’ current status including physical, mental, and social determinants of health.
• Identifies, plans, implements, and evaluates appropriate health care interventions in conjunction with the physician treatment plan.
• Collaborates with member, family, healthcare provider and team members to coordinate care and guide members to the most appropriate, cost effective resources.
• Collaborates with members, providers, staff, and stakeholders to assure continuity for members throughout different levels of care they may require.
• Provides education and referrals to appropriate community resources.
• Tracks and reports quantifiable impact, quality of care, and/or quality of life improvements as measured against long and short-term goals.
• Acts as a peer mentor for training new personnel as well as on-going training for staff.
• Conducts quality review of work completed by peers and new hires.
• Performs other duties and responsibilities as assigned.
  
  

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.