Patient Centered Medical Home (PCMH) Coordinator - Nashville Region

PLEASE NOTE: This position is Remote with some geographic restrictions. To be hired for this position, you MUSTlive in one of the following states:

Alabama (AL), Arkansas (AR), Florida (FL), Georgia (GA), Mississippi (MS), Missouri (MO), North Carolina (NC), South Carolina (SC), Tennessee (TN), Virginia (VA).

Manages member care and progress for members with identified comorbid conditions and multiple levels of risk and focuses on specific aspects of the members' condition, partnering with the Primary Care Provider (PCP) and other members of the Health Care Team (HCT).

Job Description:

BlueCross, as a federal contractor, may be required to implement a COVID-19 vaccine mandate.

Job Responsibilities

• Reviews members record using care coordination tools, EMR and other essential records to ensure member understands their chronic disease and partners with them to manage their disease. Educates members on their chronic conditions, diet, exercise and medications - ensuring adherence
• Reviews member's record using care coordination tools, EMR and other essential records to ensure member is current with preventative health screens, controlled vitals and controlled HgbA1c for those with diabetes.
• Conduct thorough and objective face-to-face visits, telephonic assessments and/or digitally outreaches with each members situation to determine current status and needs, including physical, behavioral, functional, psychosocial, financial, and employment and independent living expectations.
• Collaborates with a team of clinical and social support colleagues to meet the physical, behavioral health and long term service needs of each member and makes appropriate referrals to CCM, SW, and Dietician when member requires more in-depth assistance managing their disease and outlying factors affecting their care.
• Partnering with members and families to identify needed supports and direct services to meet personal goals for good health, employment and independent or community living.
• Various immunizations and/or associated medical tests may be required for this position.
• Position requires 12 months in role before eligible to post for other internal positions

Job Qualifications

License

• Valid Driver's License
• Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.

Experience

• 5 years - Experience in the healthcare industry required
• 3 years - Clinical experience required

Skills/Certifications

• Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
• Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
• Must be a team player, be organized and have the ability to handle multiple projects
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills
• Experience with Motivational Interviewing Techniques and Adult Learning Styles

Job Specific Requirements:

Position location will be Ascension/STMP in Nashville

Preferred Skills:

Number of Openings Available:
1

Worker Type:
Employee

Worker Sub-Type:
FlexHome

Company:
BCBST BlueCross BlueShield of Tennessee, Inc.

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST is an Equal Opportunity employer (EEO), and all employees and applicants will be entitled to equal employment opportunities when employment decisions are made. BCBST will take affirmative action to recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

All applicants will be advised that BlueCross, as a federal contractor, may be required to implement a COVID-19 vaccine mandate.

Tobacco-Free Hiring Statement

To further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test. An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotine and/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results.

Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.