Case Management Navigator

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming health care. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

The Impact You Will Have

You will work independently with non-complex members to navigate the health care system, to identify where their needs are, and match resources to help remove barriers to accessing care. You will be responsible for aiding members in finding community, financial and provider resources across multiple states and lines of business (e.g., problem solving, resource education and applicable program referrals). You will be a critical member of the Case Management team. The role is recognized by our customers as an advocate that supports our values.

*This position is remote, however preference will be given to Minnesota residents*

Your Responsibilities

• Coordinates and collaborates as an important member of the case management team to facilitate member touchpoints and enhance the overall operation of the division.
• Engages with clinical team to address patient questions or concerns and transfer/refer members to a clinical resource when appropriate.
• Independently assess member’s needs, gather accurate and comprehensive member information, and research resources and assistance programs that may be available to members in multiple states and across all lines of business. Match these resources as appropriate to support needs of members.
• Identify resource gaps internally or for the member, health plan or provider coverage needs, and raise gaps to leadership as appropriate.
• Conducts outreach to and engages members in case management programs. Works with member through the program duration and assist with non-clinical care plan goals.
• Proactively provide information and education to customers, as appropriate, about a variety of health, financial, and self-service programs.
• Serves as a member advocate by identifying underlying needs and facilitates referrals to external resources and services in the health care system, as appropriate.
• Represents members needs internally to account managers (e.g., Clinical Account Managers), clinicians and health support coordinators within Care Management, Customer service, and providers.
• Works with members across care episodes and throughout the continuum of care (e.g., financial, medical, behavioral, etc.).
• Maintain outstanding level of service at all points of member contact.
• Maintain a strict standard of confidentiality to ensure that our members protected health information (PHI) is secure.
• Display compassion, respect, and self-confidence when conversing with customers.
• Research inquiries to ensure timely resolution of issues with minimal technical support.

Required Skills and Experience

• 3+ years of related experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• General understanding of medical terminology, health insurance, and social determinants of health
• Ability to quickly gain customer trust and confidence.
• Demonstrated skills as an empathetic and compassionate communicator.
• Outstanding communication and customer service skills.
• Outstanding analytical thinking skills.
• Outstanding task facilitation skills.
• Strong computer application skills.
• Accurate record-keeping abilities.
• Demonstrate leadership ability.
• Consistently meet all performance measures.
• Demonstrated ability to enhance or develop new skills in response to changing expectations.
• Strong analytical, problem solving, and decision-making skills.
• Self-motivated, capable of working independently as well as cooperatively in a team setting.

Preferred Skills and Experience

• Strong independent research capabilities.
• LPN with MN license without restrictions or pending restrictions.

Role Designation

Teleworker

Role designation definition: Teleworking is working full time remote. Hybrid is a combination of working onsite and remotely.  Onsite is full-time onsite.

Compensation and Benefits

$26.57 - $33.21 - $39.85 Hourly

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance

• Life insurance

• 401k

• Paid Time Off (PTO)

• Volunteer Paid Time Off (VPTO)

• And more

To discover more about what we have to offer, please review our benefits page.

Equal Employment Opportunity Statement

Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic.

Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to [email protected].

All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.