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  • Manager Care Coordination - SFL

    BlueCross BlueShield of Florida · West Palm Beach , FL
    Friday, May 30, 2008

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    Description:

    M1038MAY08

    Job duties include but are not limited to the following:
    * Responsible for managing the day-to-day operations of an integrated Care Coordination unit including Concurrent Review, Discharge Planning and Case Management nurses.
    * Ensure that appropriate training, coaching and mentoring is effectively implemented in a team environment.
    * Responsible for building relationships with regional facilities, meeting with their care staff to ensure a collaborative working environment to the benefit of our members.
    * Be knowledgeable of each of the regional hospital contracts and customized requirements for care coordination. Have a working knowledge of all lines of business and its care coordination capabilities.

    Job Requirements:
    * Bachelor’s degree in a related field or equivalent experience
    * Current active Florida RN license
    * 5 or more years directly related work experience defined as 3+ years of a combination of clinical and managed care experience including 2 or more years direct supervisory experience to include concurrent reviewer/discharge planner or case manager. experience
    * Leader by example, setting clear actionable goals in a team environment.
    * Effectively work in a group/team leadership role
    * Experience in continuous quality improvement initiatives
    * Experience working with MS Word and Excel
    * 10-20% travel

    Business Specific Criteria (preferred skills):
    * Utilization Review knowledge with InterQual
    * Experience working with CMCS or CCMS systems
    * Experience working at the intermediate level with MS Word and Excel
    * Bachelor’s degree in related field
    * BCBS system experience
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