Rare Manager - Remote AZ

Join to apply for the Rare Condition Manager - Remote AZ role at Blue Cross Blue Shield of Arizona.

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:

• Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
• Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
• Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
• Onsite: daily onsite requirement based on the essential functions of the job
• Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Most employees should expect onsite requirements and at a minimum of once per week.

This remote work opportunity requires residency, and work to be performed, within the State of Arizona.

To support high-quality, cost-effective care by coordinating services for members through comprehensive case management, with a specialized focus on individuals with rare or complex conditions. This role ensures continuity of care by assessing needs, developing care plans, facilitating access to appropriate resources, and collaborating with providers to achieve optimal health outcomes.

• Work Experience: 2 years of experience in full-time equivalent of direct clinical care to the consumer
• Education: Associate’s Degree in general field of study or Post High School Nursing Diploma
• Licenses: Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN.

• Preferred
  
  Work Experience:
  
  3 years of experience in full-time equivalent of direct clinical care to the consumer (managed care CM experience preferred)
• 1-2 years of experience working in a managed care organization
• Preferred Education:
  
  Bachelor's Degree in Nursing or Health and Human Services related field of study
• Preferred
  
  Certifications:
  
  Active and current certification in case management from the following certifications;
  Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN,
  
  C), or Registered Nurse Case Manager (RN,BC).

• Perform assessments, condition management education, training, and other clinically-based activities to coordinate care among providers, members, and family to implement the care plan.
• Make and answer a diverse and high volume of condition management-related member calls on a daily basis.
• Identify holistic member needs considering whole-person health, to include condition-specific needs, behavioral health needs, and social drivers of health needs.
• Analyze medical records, claims data, and other information sources.
• Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract…