Clinical Care Coordinator
Bcidaho

Are you looking for a fulfilling position where you don't have to:

• Worry about billable hours
• Work nights and weekends
• Be on-call

And where you do have:

• Work/life balance
• Paid Time Off, including Floating Holiday and Self-Care Day
• Hybrid work schedule
• License renewal reimbursement
• Supportive team and leadership

Then consider applying to be a Clinical Care Coordinator. Clinical Care Coordinators are health care advocates creating connections, motivating healthy decisions, and helping North Idahoans receive the care they deserve!

Blue Cross of Idaho is looking for a Clinical Care Coordinator to join our growing Healthcare Operations team! The Clinical Care Coordinator will be responsible to deliver care coordination for our members using a collaborative process. In this role, you will build relationships and engage with members both in person and telephonically. You will assess, plan, implement, monitor, and evaluate member needs to ensure quality, cost effective outcomes. This position will serve members residing in Northern Idaho and will work from our Coeur d'Alene, Idaho location (hybrid opportunity).

To be considered for this opportunity you have:

Experience:

• Nurse Candidates - Three years clinical nursing or case management to include behavioral health, managed care, or geriatrics
• Social Worker Candidates - Three years advanced social work experience with an emphasis in behavioral health, medical social work, congregate care, or geriatrics.

Education: Associate degree in Nursing or Bachelor's Degree in Social Work
Licenses/Certifications - Must hold one of the following:

• Valid unrestricted Idaho Registered Nurse Licensure
• Valid unrestricted Idaho Social Work Licensure

Other: Travel Required up to 50%; Valid State of Residence Driver's License & Automobile Liability Insurance

To be successful in this position, you have the following knowledge, skills, and abilities:
Knowledge of:

• Community agencies and resources
• Multi-system outreach programs related to health care delivery, clinical education, and health-related services
• Case management and/or utilization management standards
• Quality metrics and data points
• Medicare/Medicaid regulations

Skills:

• Good interpersonal and communication
• Strong problem-solving capability
• Good written and verbal communication
• Attention to detail and accuracy
• Continuous process improvement
• Motivational Interviewing
• Microsoft Excel - Intermediate
• Microsoft Word - Intermediate
• High degree of initiative and teammate

Ability to:

• Work effectively with a wide range of populations in a diverse community
• Travel to on-site locations to facilitate community-based interactions with member
• Be an advocate for and support, encourage and motivate members
• Maintain positive working relationships with members, families, providers, and other external customers
• Build trust, actively listen, intentionally communicate, collaborate and problem solve
• Influence others toward positive outcomes
• Evaluate individual member care needs and communicate medical information to health care providers
• Work in a multicultural setting
• Demonstrate passion for helping people improve their lives

We'd also love it if you had:

• Bachelor's Degree in Nursing
• Master's Degree in Social Work
• Managed care experience
• Healthcare Insurance Industry Experience

In this role, we will ask you to:

• Conduct outreach to empower, facilitate, and educate members about the benefits of programs.
• Conduct assessments of the members' status and develops a care plan with the member to address member's goals. Assessments are conducted both in person in a member's usual care setting, by telephone, or using video conferencing.
• Identify, plan, implement, and evaluate appropriate health care interventions in conjunction with the provider.
• Facilitate coordination of care with providers. Motivate members to be active and engaged participants in their health and overall well-being.
• Help members review benefit concerns and connects with internal resources to expedite resolution of concerns and inquiries.
• Support special programs within the department.
• Provide administrative support to internal and external care management and care coordination teams.
• Coordinate and complete correspondence according to established workflows.
• Possibly coordinate and lead weekly interdisciplinary care team meetings with internal and external participants.
• Possibly coordinate and lead clinical specialty consultation team meetings with internal teams.
• Possibly provide guidance and direction for other Care Coordination staff in accordance with regulatory and/or business requirements.

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.

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