Behavioral Health Case Manager BlueCare Plus (Healthcare)

TL;DR

Behavioral Health Case Manager (Healthcare): Providing comprehensive care coordination and case management for dual-eligible members with complex behavioral health needs with an accent on integrating behavioral and physical health services. Focus on navigating Medicare and Medicaid benefits, collaborating with integrated care teams, and improving health outcomes for high-acuity populations.

Location: Must reside in the state of Tennessee. Fully remote environment with occasional required face-to-face community visits.

Company

hirify.global (BCBST) is a major healthcare insurance provider focusing on integrated care for Medicare and Medicaid populations.

What you will do

• Manage a mixed caseload of ongoing and short-term behavioral health cases for dual-eligible members.
• Coordinate care within a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP) to align behavioral and physical health services.
• Act as a liaison between members, providers, and internal/external customers to ensure seamless delivery of benefits.
• Perform full-cycle case management including assessment, planning, implementation, monitoring, and evaluation.
• Support utilization management functions for complex and non-routine cases.
• Conduct community-based case management activities, including face-to-face interactions with members.

Requirements

• Current, active unrestricted Tennessee license in Nursing (RN) or behavioral health field (Master's level or above, e.g., LCSW, LMSW, LPC, MHC).
• 3+ years of clinical behavioral health or substance use disorder experience.
• 1+ year of experience/knowledge of community care resources and behavioral health levels of care.
• Must reside in the state of Tennessee.
• Proficiency in Microsoft Office (Outlook, Word, Excel, PowerPoint).
• Sponsorship is not available for this position.

Nice to have

• Prior experience working with dual-eligible (Medicare/Medicaid) populations.
• Experience with Motivational Interviewing Techniques and Adult Learning Styles.

Culture & Benefits

• Fully remote work environment (supporting Tennessee members).
• Innovation-driven culture encouraging the responsible use of AI-enabled tools to optimize workflows.
• Inclusive work environment with equal opportunity hiring and promotion policies.