Job Description
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 healthcare. 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 This position will work independently to navigate the health care system, identify where customer needs are, and match resources to help remove barriers to accessing care. The Care Management Navigator will work in collaboration with internal teams, members and providers to support run-the-business needs. This position provides advanced support to Care Management Operations leadership. The Navigator is a critical member of the Care Management team and is recognized by our customers as an advocate that supports our values.
Your Responsibilities - Maintain outstanding level of service at all points of customer 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.
- Represent members needs internally to account managers (e.g., Clinical Account Managers), clinicians and Health Support Coordinators within Care Management, Customer Services, and providers.
- Assist members and providers in obtaining needed information essential to the care management process.
- Engages with clinical team to address patient questions or concerns and transfer/refer members to a clinical resource when appropriate.
- Coordinates and collaborates as an important member of the care management team to enhance the overall operation of the division.
- Identify resource gaps internally or for the member, health plan and/or provider coverage needs. Provide feedback to leadership as necessary.
Behavioral Health (BH) Case Management
- Conducts outreach to and engages members in case management programs, working with members across care episodes and throughout the continuum of care (e.g., financial, medical, behavioral, etc.).
- Independently assesses member’s needs, gathers accurate and comprehensive information, and leverages expertise to design non-clinical plan of care, assist in next steps, and advocate for member needs.
- Proactively identifies appropriate opportunities for support by providing information and education to members about a variety of health, financial, and self-service programs, then placing referrals for accepted resources.
- Serves as a member advocate; researches resources and assistance programs that may be available to fill gaps, helps to reduce barriers in accessing community resources, provides encouragement for involvement in community supports that support recovery goals and interests.
- Collaborates with care management team, consults where pertinent, & communicates with member to help with recovery goals.
- Shares personal stories of resilience & recovery where applicable with members experiencing behavioral health conditions.
Required Skills And Experience - 3+ years of related experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
- Level II Certified Peer Specialist certification which meets all requirements of a level I Certified Peer Specialist (CPS) and is a qualified mental health practitioner per DHS requirements or Certified Peer Recovery Specialist Reciprocal (CPRSR).
- 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 problem solving and decision-making skills.
- Self-motivated, capable of working independently as well as cooperatively in a team setting.
- High school diploma (or equivalency) and legal authorization to work in the U.S.
Preferred Skills And Experience - Background in healthcare or related field.
- Strong independent research capabilities.
- Experience with medical terminology or coding.
- Demonstrated ability to work across functional areas within the organization.
Compensation And Benefits Pay Range: $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.
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