Case Manager RN - Remote Florida

What are Key Responsibilities:

• Engage Members telephonically or face to face at Florida Blue Retail Centers, hospitals, etc. with a focus on health coaching and member education. Facilitate access to care and resources to meet the member's health care needs. Provide education and tools to promote self-management.
• Plan, implement, coordinate and monitor Case Management activities that may include acute and non-acute services, outpatient services and or community resources.
• Facilitate care for high risk members across the continuum of the health care experience, including care transitions, coordination of community and social service and coordinating with other value-based organizations, providers as needed.
• Close gaps in care and conduct Medication Reconciliation
• Collaborate with Member, Member's Physicians, Plan Medical Directors, Managers, Local, Regional and Specialty team members as well as other functional areas to assist the member to meet their health care goals.
• Promote healthy lifestyles, assist in strengthening the patient-physician relationship, encourage behavior and lifestyle changes to realize a better quality of life, for individuals with identified chronic conditions, costly and/or catastrophic illnesses. (
• Assist Members and their physicians to navigate through the health continuum, educate regarding benefits, identify candidates for Care Programs and provide information pertaining to the network and network access.
• Facilitate and document interdisciplinary care team meetings for at risk members as appropriate.

What is Required:

• 2+ years' experience in communicating and building relationships with members/providers/employers both telephonically as well as virtually
• Florida RN - Registered Nurse Licensure And/Or Compact State Licensure Unrestricted License
• Experience with influencing and motivating individuals to change health behaviors
• Population health knowledge and/or experience
• Experience in two or more of the following: home health care, utilization review, discharge planning, disease/ case management
• Experience working with Managed Care products, benefits and services
• Experience in planning, implementing coordinating and monitoring activities that focus on acute and non-acute services, outpatient services and/or community resources for all lines of business
• Openness to meet member's availability, on occasion, outside of traditional work hours
• Basic to intermediate experience in MS Word, Excel, tablet and/or smartphone
  
  

What is Preferred:

• Bachelor's degree in a related field
• CCM - Certified Case Manager License
• Bilingual English/Spanish

General Physical Demands
Sedentary work: Exerting up to 10 pounds of force occasionally to move objects. Jobs are sedentary if traversing activities are required only occasionally.

Physical/Environmental Activities
Must be able to travel to multiple locations for work (i.e. travel to attend meetings, events, conferences). Occasionally

What We Offer:
As a Florida Blue employee, you will thrive in our Be Well, Work Well, GuideWell culture where being well as an individual, and working well as a team, are both important in serving our members and communities.

To support your wellbeing, comprehensive benefits are offered. As an employee, you will have access to:

* Medical, dental, vision, life and global travel health insurance;

* Income protection benefits: life insurance, Short- and long-term disability programs;

* Leave programs to support personal circumstances;

* Retirement Savings Plan includes employer contribution and employer match;

* Paid time off, volunteer time off, and 11 holidays

* Additional voluntary benefits available; and

* A comprehensive wellness program
Employee benefits are designed to align with federal and state employment laws. Benefits may vary based on the state in which work is performed. Benefits for intern, part-time and seasonal employees may differ.

To support your financial wellbeing, we offer competitive pay as well as opportunities for incentive or commission compensation. We also conduct regular annual reviews with pay for performance considerations for base pay increases.

Typical Annualized Hiring Range: $68,100 - $85,100, within annualized range of $68,100 - $110,600

Final pay will be determined with consideration of market competitiveness, internal equity, and the job-related knowledge, skills, training, and experience you bring.

We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive and equitable culture for our employees and communities.