A Career of Your Calling

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

This position is fully remote however the candidate must live in MN

The Impact You Will Have
The Transition of Care (TOC) Support Coordinator is a vital and valued member of the Transition of Care Management team and is responsible for cross-functional support within the Care Management (CM) department. In this role, the TOC Support Coordinator provides support to CM clinicians and programs supporting transitions of care and chronic care management.A major responsibility will be to provide customer service to both internal and external customers telephonically or through written inquires which typically involve reviewing admission notifications, concurrent and post-service review requests, program referrals, and appropriate triaging for case management, disease management and behavioral health management programs.This position specifically focuses on providing optimal transition of care services to members using a stratification tool and Eric Colemans 4 Pillars of Care as members discharge to home. The TOC Support Coordinator conducts meaningful post discharge welcome home calls, manages work queues by triaging members to appropriate programs following discharge to medical or behavioral Health Coaching and/or refers members to appropriate community resources.

Your Responsibilities

• Receives, researches, prioritizes and responds to Transition of Care (TOC), and/or other program referrals through mailbox management system, work queue management, incoming telephonic and written pre-service, post-service and concurrent care requests.
• Completes the stratification tool (such as the LACE tool) for all discharges and triages cases based on Eric Colemans 4 Pillars of Care.
• Conducts outbound calls to members/family caregivers, providers and facilities.
• Receives, manages and/or routes inbound calls from members, providers, customer service, or other internal collaborators per process.
• Maintains an outstanding level of customer service throughout all points of customer contact.
• Triages written requests to appropriate clinical staff in a timely manner and according to established practices, workflow processes, and departmental needs.
• Accurately applies specific guidelines, policies, and procedures as authorized by the clinical review areas and in coordination with TOC/case management activities.
• Researches appropriate systems for medical record information and prepares medical record information and sets up and assigns to clinical review staff.
• Checks daily activity reports and adjusts work priorities accordingly.
• Establishes and maintains relationships with both internal and external customers.
• Provides regular back-up assistance to other team members.
• Accepts accountability for special projects, assignments or reports that are more difficult in nature and require moderate to complex research, analysis, and documentation skills.
• Recognizes opportunities for workflow process improvement and initiates workflow changes with leadership.
• Cross-trains with demonstrated accuracy in multiple intake and support functions.
• Assists with pilot projects and other duties as needed.

Required Skills and Experience

• 3+ years of related experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• Excellent data entry skills and attention to detail and accuracy.
• Demonstrated time management skills.
• Effectively applies and demonstrates workflow instructions and successfully meets turn-around-time expectations.
• Proficient in MS Office Suite, including Access.
• Strong interpersonal and verbal and written communication skills; ability to express moderate to complex issues to individuals, groups, internal and external contacts, and writes clear, concise and grammatically correct materials.
• Strong organizational, research, and analytical skills.
• Demonstrated decision making and problem-solving skills.
• Demonstrated ability to effectively deal with escalated situations.
• Positive, professional, service-oriented behavior.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills and Experience

• Bachelor or Associate degree in business or health related field or health related licensure 1-year equivalent work experience in customer service.
• Current call center environment training and experience.
• Working knowledge of BCBSMN products and systems.
• BCBSMN Provider or Customer Service experience.
• Medicare and Medicaid knowledge.

Compensation and Benefits:

Pay Range: $21.00 - $26.25 - $31.50 Hourly

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

To discover more about what we have to offer, please review our benefits page.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.

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