Field Nurse Case Manager RN (Bismarck)

Job Summary

This position has the opportunity to work remotely serving the Southwestern portion of the state of ND while traveling 75% of the time. 

The Field Nurse Case Manager reviews cases of members with acute or chronic conditions and collaborates with service providers, the patient and family, and internal resources (e.g. Medical Review) to establish the most effective treatment plan within the provisions of the policy. This position works directly with members and their families in addressing medical and social concerns on-site in a variety of settings and collaborates with management to assess, plan, implement, coordinate, monitor and evaluate services and outcomes to maximize the health of the member. The Field Nurse Case Manager understands nursing processes, nursing documentation and current standards of nursing practices and applies this knowledge throughout the continuum of care.

Essential Functions

• Identifies and assesses members with acute or chronic conditions for possible case management (CM) intervention. Develops, coordinates and monitors a care plan for members with case management member centric plan of care needs and educates both member and health care team of services allowed within the benefit plan.
• Meets with members in a variety of settings to provide management of services. Conducts comprehensive assessment to include home safety and social determinants of health to determine health care needs for the member.
• Develops a case management care plan by initiating contact with the member/designated representative and their health care provider team after obtaining case management program consent from the member. Assesses initial and ongoing needs with the member/family, health care team and case manager by completing a thorough assessment of medical records and contact with providers and patient.
• Collaborates in identifying appropriate alternatives to the present care and provides assistance with identified needs by collaborating with the member and member’s health care team.
• Participates in discharge planning, networking with appropriate outside agencies and making appropriate referrals to alternative resources as needed.
• Documents case information and practices per CM policy and procedures and in accordance with current documentation.
• Collaborates with internal and external medical, utilization management and customer services teams throughout the case management process to coordinate the member’s care plan as needed.
• Educates members and families to make informed personal health care decisions.

 

Knowledge, Skills and Abilities

Clinical Expertise

Advanced

Effective Interpersonal Communications

Advanced

Decision Making

Intermediate

Flexibility and Adaptability

Intermediate

Collaboration

Intermediate

Attentiveness and Listening Skills

Intermediate

 

Education Requirements

Required: Associate's

Preferred: Bachelor's

Field(s) of Study: Completion of RN program is required; BSN is highly preferred.

 

Experience Requirements

Required: Minimum of 3 Years

Preferred: Minimum of 5 Years

Experience Details: Minimum of 3 years of of clinical or related experience is required; previous case management and home health experience is highly desirable.

 

Certification, Licensures & Registration Requirements

Title: North Dakota (ND) Registered Nurse (RN) License or RN License valid for work in ND

 

 

State or Agency: Board of Nursing

Title:  Must maintain an active and valid/unencumbered driver’s license which allows for standard driving privileges in North Dakota and Minnesota

 

State or Agency: Department of Motor Vehicles

 

Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

 

Physical Demands

Sitting

Frequent (60-90%)

Use of Computer, Telephone or Other Devices

Frequent (60-90%)

Talking

Frequent (60-90%)

Travel

Frequent (60-90%)

Standing

Rare (0-30%)

Walking

Rare (0-30%)

Other Information

Important Notice

BCBSND has a vaccination protocol in place that requires any employees who physically work in a BCBSND office or whose role requires direct customer contact to be vaccinated against COVID-19. We respect your choice to get vaccinated (or not) and getting vaccinated is not a condition of employment. If you are not vaccinated, you may work remotely if your role allows for it. If your role does not allow for remote work and you are unable to get the COVID-19 vaccine, there is an exception process available that includes a weekly testing regimen.

 

Job Posting Policy

Employees new to Blue Cross Blue Shield of North Dakota are eligible to apply for positions within their assigned department after successfully completing 90-days in their role. For positions outside of their department, new employees should attain a minimum of six months of service before applying for a new role. Exceptions to this are acceptable, provided there is good business justification for making the move.

 

Equal Opportunity Employment

Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity.

For questions, please email careers@bcbsnd.com

This job posting will be closed 1/28/2022 at 8:00AM CST. No further applications will be considered.