Case Management Navigator

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.

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*

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.