Full-Time

RN Clinical Care Guide-Case Management Exp-Tucson River & Campbell

Onsite

Posted on 11/21/2024

Blue Cross Blue Shield

Blue Cross Blue Shield

1,001-5,000 employees

Healthcare

Mid, Senior

Tucson, AZ, USA

Position will work out of Tucson Williams Circle location.

Category
Nursing & Allied Health Professionals
Medical, Clinical & Veterinary
Required Skills
Customer Service
Requirements
  • Excellent interpersonal skills to include maintaining courteous, friendly and effective communications with patients, team members and external parties
  • Current active unrestricted state license to practice as a Registered Nurse
  • BLS certification within 30 days of hire
  • Electronic Medicare Records experience
  • Customer service orientation and experience
  • Strong communication skills across multiple modalities
  • Highly collaborative
  • Empathy and advocacy
  • Exceptional organizing skills, detail-orientation
  • Must be able to maintain confidentiality at all times
  • Fingerprint clearance to be obtained within 30 days of hire
  • Immunization records or documentation of immunity for all required immunizations must be provided prior to hire or placement in the role. Employees who have not received immunizations for COVID or an annual flu vaccine and have provided documentation of an exception for medical or religious reasons will be required to wear a properly fitting mask while in any Prosano Clinic or as required by management.
Responsibilities
  • Support members both in-person and virtually with real-time consultation, education, scheduling of specialist & diagnostic referral appointments, and follow-through + follow-up of those appointments
  • Play a critical role in the achievement of improved health outcomes and cost savings
  • Be an empathetic problem-solver and become the most visible partner to all patients
  • Clarify and explain referral for specialist and diagnostic service recommendations
  • Care for end to end process as needed, for referral or specialist services
  • Lead center in development and management of quality programs to include patient outreach to members in an effort to provide an elevated primary care experience with gaps in care or other clinical needs
  • Support members with chronic conditions by providing education, reminders, and other support
  • Handle the management and integration of office processes
  • Lead service and schedule requests on member’s behalf
  • Inform and equip Care Team with referral information and requirements
  • Be an ambassador in the local community - building relationships with other healthcare providers, social/community organizations, and marketing partners
  • Perform all other duties as assigned
Blue Cross Blue Shield

Blue Cross Blue Shield

View

Company Stage

N/A

Total Funding

N/A

Headquarters

Chicago, Illinois

Founded

N/A

Growth & Insights
Headcount

6 month growth

-8%

1 year growth

-8%

2 year growth

-8%
Simplify Jobs

Simplify's Take

What believers are saying

  • The Blue Distinction Centers program enhances BCBS's reputation by associating it with high-quality healthcare providers, potentially attracting more members.
  • Collaborations with organizations like Folx Health and the American Spine Registry demonstrate BCBS's proactive approach to expanding and improving healthcare access and quality.
  • The promotion of Michael Gardner to VP, Enterprise Data, suggests a focus on leveraging data for strategic growth and operational efficiency.

What critics are saying

  • The $2.8 billion antitrust settlement against BCBS highlights potential legal and financial vulnerabilities that could impact its operations and reputation.
  • The dismissal of the lawsuit over COVID-19 test claims may not fully mitigate reputational damage from perceived underpayment issues during the pandemic.

What makes Blue Cross Blue Shield unique

  • Blue Cross Blue Shield's Blue Distinction Centers program sets it apart by recognizing healthcare facilities that demonstrate high-quality care and efficiency in specialty areas like spine surgery and joint replacement.
  • The collaboration with Folx Health to expand LGBT-affirming care highlights BCBS's commitment to inclusivity and addressing diverse healthcare needs.
  • BCBS's partnerships with organizations like the American Spine Registry and the American Joint Replacement Registry enhance its ability to evaluate and designate high-quality healthcare institutions.

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