RN Case Manager, FEP Behavioral Health

October 17, 2024

Full Job Description

Healthy Careers Start Here

At Blue Cross & Blue Shield of Mississippi, we encourage professional growth in a challenging and fast-paced atmosphere. Our 'be healthy' culture promotes health and wellness at all levels of the Company, and we provide our employees with the time, tools and resources to commit to a healthy lifestyle.

Job Summary:

The FEP Behavioral Health Case Manager is responsible for the management of FEP members with behavioral health care needs. The FEP Behavioral Health Case Manager is accountable for providing clinical support to FEP members by facilitating an appropriate plan of care for optimal outcomes, encouraging members to become engaged, and facilitating the provider and member relationship for quality and cost-effective care.

The incumbent will thoroughly understand the NCQA Case Management standards/guidelines and will apply the principles of case management to facilitate a comprehensive member and provider process for members requiring behavioral health care services, which includes member assessment, discharge planning and education, coordination of care, progress documentation and adherence, clinical monitoring, outcomes reporting, provider compliance with the plan of care, and overall case management functionality.

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Job-Specific Requirements:

Bachelor’s degree in Nursing is required.
Registered Nurse with an unrestricted license in the state of Mississippi is required.
At least three years of behavioral health care clinical experience is required.
Case management experience is preferred.
Case Management certification (CCM) preferred or eligible for certification within two years of employment.
Knowledge of NCQA Case Management standards is preferred.
Ability to communicate with Members, their caregivers and Providers.
Ability to work with a high degree of accuracy and attention to detail is required.
Must have excellent organizational skills in order to successfully prioritize tasks and to ensure deadlines and benchmarks are consistently met.
Excellent planning, problem solving, and analytical skills are required.
Excellent research and oral/written communications skills are required.
Must possess strong interpersonal skills with the ability to build strong relationships to encourage trust and open communication.
Must have the ability to handle information of a confidential nature.
Must have working knowledge of Microsoft Office suite.
Knowledge CPT, HCPCS, ICD 10 coding is desired.
Must be able to work a flexible schedule when required.

Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field. We are looking for employees who can bring their experience, expertise and dedication to work for our customers.

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Full Job Description

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