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Blue Cross Blue Shield of TennesseeThe Volunteer State Health Plan, Inc. (VSHP) CHOICES program offers person-centered care planning, service coordination, and support services for members receiving long-term care and home and community based services. The care coordination manager is responsible for providing leadership and oversight of the care coordination division, which promotes interdependent collaboration with the member, physician/primary care manager, and member's family. In addition, the care coordination manager plans, develops, and administers guidelines, policies, and procedures related to care coordination and utilization management; evaluates and enhances the efficiency, effectiveness, and quality of work flow; and analyzes and presents data to monitor service outcomes and fulfill organizational and governmental reporting requirements. This position requires travel.  Position covers the East Grand Region and may work out of any of the offices in Chattanooga, Knoxville or Johnson City. Job Duties & Responsibilities:• Management of supervisory level personnel and care coordination staff. • Participate in hiring and conducting ongoing training of the care coordination team. • Ensure compliance with federal, state, and agency policies, procedures, and standards through documentation review, clinical outcomes analysis, and staff education. • Plan, develop, and administer guidelines, policies, and procedures related to care coordination services, utilization management, continuum of care, and transitional/discharge planning initiatives. • Evaluate and enhance the efficiency, effectiveness, and quality of work flow, and lead performance improvement efforts to identify opportunities for improvement and to implement best practice solutions. • Develop and maintain reporting mechanisms to allow for tracking, trending, and monitoring of initiatives and outcomes. • Facilitate gathering, analyze, and present data to comply with VSHP and TennCare reporting requirements. • Interact, facilitate, and establish partnerships and collaborations with TennCare, referral sources, community resources, and care providers. • Serve as a liaison for the care coordination division and VSHP management.Education:• Registered Nurse with an active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Act preferred or a Master's degree in a Behavioral Health field or Social Work with a current, unrestricted license in the state of Tennessee or a Master's degree in Health Care in Administration, MPA, MPH or other graduate degrees in related health or insurance disciplines.Experience:• 3 - 5 years experience providing care coordination to persons receiving long-term care and/or home and community based services and an additional 2 years work experience in managed and/or long-term care setting required. • Minimum of 5 years of supervisory/management experience.Skills/Certifications• Exceptional interpersonal skills, with the proven ability to lead, delegate, and follow-up and resolve conflict. • Excellent written and oral communication skills (including presentation and team facilitation). • Demonstrated analytical, design, implementation, and system skills preferred. • Extensive computer skills with direct experience in MS Office, Word, PowerPoint, and Excel required; Visio and Project preferred • Must be self-motivated and able to manage multiple tasks and priorities within specified time frames. • Valid Driver's License • Ninety (90) % day travel required • Employee may be required to participate in Runzhimer Program (auto reimbursement plan)Please apply via our career site at:https://www.bcbst.com/about/careers/openings/