Nurse Guide Commercial Operations Job:
Blue Cross and Blue Shield of Minnesota

9141-en_US
Blue Cross and Blue Shield of Minnesota
Mn
Healthcare
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Description

 



About Blue Cross



Founded in 1933, Blue Cross and Blue Shield of Minnesota is the largest health plan in the state. We have more members, the largest network of providers and more products and services than any other plan in Minnesota. From the beginning, Blue Cross has been an innovator with a mission of making a healthy difference in people’s lives.



We understand the importance of finding a job that you truly enjoy — at a company that shares your values. We’ve made it easy to feel good about working at Blue Cross by encouraging volunteerism, valuing diversity and offering the flexibility you need to live a balanced life. We offer a suite of comprehensive medical and dental benefits as well as competitive pay, flexible work schedules and generous personal paid time off in addition to 20 hours of volunteer paid time off each year. We look forward to serving Minnesotans over the next 80 years and beyond. Join us and make a healthy difference through the work you do every day.


Description Summary

The Nurse Guide is a critical component of BCBSM’s Integrated Health Management team. Generally, the position exists to provide member education, support and referrals. A Nurse Guide engages the member and helps him or her to navigate the healthcare system. Specifically, the position serves members with a variety of health care needs, responds to member inquiries for clinical and resource information and focuses on quality, cost–effective care.

Accountabilities

1) Initiates assessment utilizing clinical knowledge, BCBSM tools; e.g. systems and knowledge of health plan benefit structure.



2) Responds to members’ health related questions and concerns while teaching members how to better manage their own health.



3) Identifies opportunities for connecting members to group related benefits; e.g. Nurse Line, Employee Assistance Program, Dedicated Nurses, Dedicated Behavioral Health Clinical Specialists or other specialists within BCBSM Health Management Division.



4) Educates members on the use of the health care delivery system.



5) Participates as a resource to internal and external customers.



6) Maintains outstanding level of service at all points of customer contact.



7) Demonstrates the behaviors inherent to the “Find a Way” culture; e.g. continuous learning, innovation to facilitate day to day accountabilities and enhance the overall performance of the department.


Requirements


  • Registered nurse with current MN license with no restrictions.

  • 3 years relevant clinical experience.

  • Outstanding communication skills.

  • Outstanding analytical thinking skills.

  • Outstanding task facilitation skills.

  • Computer application proficiency.

  • Flexibility to work varied hours


Preferred Requirements


  • 1 year of medical call center or managed care experience; e.g. case management, utilization management and/or auditing experience

  • Outstanding telephonic skills


FLSA Status

Exempt

Blue Cross Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



 



Make a difference



Thank you for your interest in Blue Cross. Be part of a company that lets you be you — and make a healthy difference in people’s lives every day



Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association

Basic Qualifications
Requirement