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 provide care coordination for our members utilizing 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 Eastern Idaho including Pocatello, Idaho Falls, and surrounding areas and will work from either our Chubbuck or Idaho Falls location.
To be considered for this opportunity you have:
- Social Worker Candidates - Three years social work with an emphasis on behavioral health, geriatrics, and/or medical social work
Bachelor's in Social WorkLicenses/Certifications - Must hold one of the following:
- Valid unrestricted Idaho Social Work Licensure
Travel Required up to 50%; Valid State of Residence Driver's License & Automobile Liability InsuranceTo 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
- Strong interpersonal and communication
- Strong problem-solving capability
- Strong 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 team player
We'd also love it if you had:
- 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 professionals
- Work in a multicultural setting
- Demonstrate passion for helping people improve their lives
In this role, we will ask you to:
- Master's Degree in Social Work
- Managed care experience
- Healthcare Insurance Industry Experience
- Conduct outreach to motivate, facilitate, and educate members about the benefits of programs.
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.
- 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.