Blue Cross of Idaho Sup Care Coordination in Meridian, Idaho

Supervise the day-to-day activities of staff performing case and disease management activities. Support programs and assist in developing programs and initiatives for the Dual Medicare/Medicaid lines of business. Work effectively with other Healthcare Operations leadership and represent Blue Cross of Idaho to external providers, employer groups, and brokers.

  • Experience:

  • Three years’ direct patient care clinical nursing to include acute inpatient care, medical and surgical inpatient and/or outpatient care or specialty care (preferably cardiovascular, endocrinology, oncology and/or respiratory)

  • Two years’ leadership

  • Education: Bachelor’s Degree in Nursing; OR Master’s Degree in Social Work

  • Certifications/Licenses:

  • Valid unrestricted Idaho Registered Nurse License; OR

  • Valid unrestricted Idaho Social Worker License

Knowledge, Skills and Abilities (KSAs):

Knowledge of:

  • Managed care delivery systems including Medicare/Medicaid plans

  • Reporting requirements

  • Utilization management

  • Care Coordination /Case Management

  • Quality Improvement (QI)

  • National Commission on Quality Assurance (NCQA) accreditation standards

  • Center for Medicare and Medicaid Services (CMS)

Skills:

  • Customer service

  • Organizational

  • Time management; Prioritize work

  • Technical writing/business writing

  • Verbal and written communication

  • Detail oriented

  • Microsoft Office (Word, Excel, Outlook) – Basic

Ability to:

  • Prioritize work and manage multiple initiatives

  • Keep up-to-date on State and Federal regulations and accreditation standards

  • Give and receive constructive feedback in a team environment

  • Effectively monitor and maintain staff performance levels

Preferred Qualifications:

  • Previous Health Plan experience

Position Reports to: Manager Duels Internal Posting Date: 1/4/2019 - 1/11/2019

Job ID #: 2057

Location: Meridian, ID (Corporate Headquarters)

Job Category: Nursing

Education Required: Bachelors Degree

Employment Type: Full Time

Experience Required: 3 - 5 Years

Relocation Provided: No