Concierge Care Manager

Summary
 We are currently hiring for a Concierge Care Manager to join BlueCross BlueShield of South Carolina. In this role as Concierge Care Manager, you will provide care management services to more than 2 million members in South Carolina and nationally. You will administer complex, high-touch concierge case management for members identified into specialized programs such as high-risk maternity, NICU, ESRD, and Palliative Care Behavioral Health. You will also identify risks and provide outreach services to facilitate the coordination of healthcare services and gap closure. Provides individualized care plans to ensure cost-effectiveness, overall care satisfaction, and improved quality of life.

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.
Description
 

Logistics: About Us​ | BlueCross BlueShield of South Carolina

Location: This position is full time (40 hours/week) Monday-Friday and will be fully remote (Work at Home). To work from home, you must have high-speed (non-satellite) internet and a private, secure home office.

What You’ll Do:

• Direct day-to-day, high-touch member management to include implementation of program goals, coordination of treatment plans, and benefit coordination for high-risk patient populations and/or those with complex conditions.

• Coordinate clinical services with external sources, including providers, vendors, facilities, social workers/case managers, and/or community services.

• Participate in team training and continuing medical education.

• Prepare for external audits and quality assurance efforts.

To Qualify for This Position, You'll Need the Following:

• Required Education: Associate’s degree in nursing; OR Graduate of Accredited School of Nursing. For Div 75 and 6B requires Master's degree in Social Work, Psychology, or Counseling.

• Degree Equivalency: Degree Equivalency not applicable for the Celerian Group, Bachelor’s degree required.

• 5 years' case management experience as a …