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Registered Nurse

Blue Cross and Blue Shield of Illinois, Montana, N

This is a Contract position in Chicago, IL posted May 14, 2019.

Description: We are the Health Care Management division of HCSC
– a team of dedicated nurses, doctors and other clinicians.

Everything we do, and every decision we make, aims to help our members live their most healthy lives.

We treat the whole person with integrated pharmacy, physical and mental health care benefits.

We’re also tackling the social determinants of health by creating non-clinical partnerships in the communities where we work and live, because everyone should have access to quality health care.

We use innovative tools and approaches to help members get the most out of their plan benefits, as affordably as possible.

We are more than a health care insurer and we are truly anchored in our purpose: to do everything in our power to stand by our members in sickness and in health.

Job Purpose: This position will be responsible for focusing on the overall health of the member by assisting the member with the goal of increased health and overall wellbeing by developing a one-to-one relationship with the member.

Encourage members to utilize appropriate resources and web based tools available to them to access information regarding their condition as well as track progress towards wellbeing goals.

This position is also responsible for guiding the member through transitions in care, handling a member’s complex needs as well as acute and chronic conditions.

Additionally, this position will receive referrals focusing on member wellbeing; including diagnosis based, overall medical cost, identified treatment gaps, frequent Emergency Room utilization, pre-admission/post-discharge follow-up, etc.Required Job Qualifications: Registered Nurse (RN) with current, valid, unrestricted license in The State of Texas 2 years of clinical practice experience of direct clinical care to the consumer 1 year of experience in care management/condition management PC proficiency to include Word, Excel, Outlook and database experience Clear and concise verbal and written communication skills Familiarity of ancillary services including HHC, SNF, Hospice, etc Analytical skills Decision making skills and sound clinical judgment to provide oversight of other staffPreferred Job Qualifications: 3 years of clinical practice experience of direct clinical care to the consumer Experience in managing complex or catastrophic health cases Specialty clinical experience in intensive care medicine, orthopedic, NICU/pediatric, oncology, diabetic member management, obstetric (low to high risk maternity management) Working toward or completion of CCM/CCP/CDE/MCG certification or Advanced degree Knowledge of Milliman Guidelines or similar clinical guidelines Knowledge of medical management policies and procedures Case management experience Location: IL
– Chicago, TX
– Richardson Activation Date: Thursday, April 25, 2019 Expiration Date: Tuesday, May 14, 2019 Apply Here