Find Jobs

All about us

You likely know us as an insurance company, but that's just a portion of what we do. Hundreds of thousands of North Dakotans trust us to provide them with personalized service and unmatched access to care. It's a mission we take seriously.

We also work with entities throughout the state to challenge the cost and complexity of health care in North Dakota. This uncompromising goal requires caring, innovative people who are ready and willing to help create a new level of health and well-being in North Dakota and beyond.

Work environment

This opportunity is eligible for a remote, hybrid or in-office work arrangement. We empower our employees to find a work style that is best for them. Learn more at Life at Blue | BCBSND.

This position is eligible for internal Blue Cross Blue Shield employees and external applications.

Pay information

Pay Level: 023

FLSA Category: Exempt-Salaried

A day in the life

The Behavioral Case Manager is responsible for reviewing 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 screens, assesses and develops case recommendations, educates patients and family, coordinates with providers and monitors and documents case(s) on an ongoing basis.

Your responsibilities will include

• Identifies and assesses members with acute or chronic conditions for possible case management (CM) intervention. Develops, coordinates and monitors a plan of care for members with case management needs and educates both member and health care team of services allowed within the benefit plan.
• Develops a case management plan of care 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 providing 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 CM accreditation standards.
• Verifies member benefit eligibility for alternative care for medical necessity and appropriateness and initiates the request for service.
• Throughout the case management process, collaborates with internal and external medical, utilization management and customer services teams as needed in the collaboration and coordination of the member's care.

What you need to succeed

• Associate's degree/completion of an RN program
• 3 years of clinical or related experience.
• Some experience in behavioral health.
• Previous case management experience is highly preferred with a good understanding of a variety of clinical concentrations.
• Comfortable with calling members and spending time on the phone.
• Intermediate computer skills with the ability to learn different systems.
• Strong ability to speak to and work well with members, designated representatives and health care providers.
• Have a desire to collaborate while also being adaptable and flexible to the needs of our members.
• Good decision making skills around care and case management.

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

Benefits and perks

• Wellness incentives including well-being lifestyle spending accounts, employee assistance program and employee discounts.
• Encouraged paid time off including paid holidays and flexible holidays to use as you wish.
• 16 hours of paid volunteer time with a $200 donation to a charity of your choice upon completion of all volunteer hours.
• Employee recognition, community initiative events and yearly company outings.
• Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments.
• Our core benefits include health, dental, vision and life insurance, short-term and long-term disability and paid parental leave.

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 .

This job posting will be closed 6/7/2024 at 8:00 a.m. (CT). No further applications will be considered.