Medical Case Manager (Hamblen, Greene County)

Location: Remote within the USA; candidates must reside in Hamblen or Greene County, Tennessee, and travel for at least monthly in-person home visits.

Company

hirify.global provides health insurance and care coordination services through SelectCommunity.

What you will do

• Assess the health, functional, behavioral, mental, social, and emotional needs of members with intellectual and developmental disabilities.
• Develop and coordinate individualized, integrated plans of care with members, caregivers, conservators, and providers.
• Coordinate long-term services, supports, insurance benefits, and Department of Disability and Aging benefits.
• Oversee complex cases, implement interventions, monitor outcomes, and support efficient benefit utilization.
• Conduct telephonic contacts and in-person home visits as required by the TennCare contract.
• Support utilization management and serve as a liaison among members, providers, and internal and external customers.

Requirements

• Active Tennessee RN license, or a license in the employee’s state of residence if participating in the Nurse Licensure Compact.
• At least 3 years of clinical experience and 5 years of experience in the healthcare industry.
• At least 2 years of experience working with individuals with intellectual and developmental disabilities for SelectCommunity.
• Residence in Hamblen or Greene County, Tennessee, with the ability to travel for member visits.
• Excellent oral and written communication skills.
• Basic PC skills, including Microsoft Office and email; digital literacy assessment required.

Culture & Benefits

• Full-time employee position with one available opening.
• Routine business driving requires participation in the BCBST Driver Safety Program.
• Employees driving for business must maintain a valid driver’s license, compliant auto insurance, and an acceptable motor vehicle record.
• Various immunizations and associated medical tests may be required.
• An 18-month commitment is required before applying for other internal positions.