Blue Cross and Blue Shield of Louisiana Jobs

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Blue Cross and Blue Shield of Louisiana RN Trainer/Program Coordinator in Baton Rouge, Louisiana

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.

Please note that effective Jan. 4, 2022, Blue Cross and Blue Shield of Louisiana implemented a policy requiring any employee who enters any of our offices or who interacts in person with anyone for company business purposes to be fully vaccinated for COVID 19, unless legally entitled to a reasonable accommodation related to religious or medical exemptions. At this time, that policy is suspended and vaccination is not required to enter our facilities. Please note this is subject to change at any point in time to ensure compliance with company policy or government mandates and certain client facing roles may have separate protocols.

Residency in or relocation to Louisiana is preferred for all positions.

POSITION PURPOSE

Responsible for coordinating program assessments, planning and implementation of training plans for ongoing changes and improvements in BC programs and coordinating external communications from Medical Management about Medical Management programs and program results.

NATURE AND SCOPE

  • This role does not manage people

  • This role reports to this job: MANAGER, CLINICAL TRAINING - CARE MANAGEMENT

  • Necessary Contacts: Benefits Administration, Medical Directors, Underwriting, Marketing & Sales, Provider Contracting, Legal, Claims Staff-Vendors contracted for MM services, Product Vendors for software support, Providers, Clients, Account Insight, etc.

QUALIFICATIONS

Education

  • Bachelor's in nursing, business administration, healthcare, computer science or a related field is required or

  • In lieu of degree an RN license is required or

  • In lieu of degree an LPN license to practice in Louisiana as well as 2 years of related experience is required

Work Experience

  • 5 years of combined experience in direct patient care and/or training in a clinical or managed care environment is required

  • Experience in managed care or healthcare-related field and experience with multiple insurance products, i.e., ASO, FEP, Fully funded, etc. is preferred

  • Experience in the use of multiple software programs such Care Management software, and Project and Visio is preferred

Skills and Abilities

  • Must demonstrate ability to implement training programs.

  • Must demonstrate ability to analyze and organize data to produce information for various audiences.

  • Working knowledge and proficient in the use of Microsoft Office programs such as Outlook, Word, PowerPoint, Excel, and Access is required.

  • Knowledge of medical terminology, CPT, ICD-10, HCPCS and other procedural coding is required.

  • Excellent verbal, written and interpersonal communication skills and demonstrated ability to communicate effectively at multiple levels of the organization and to multiple internal and external audiences are required.

  • Requires demonstrated adaptability and flexibility to changes and response to new ideas and approaches in education, training and staff development

  • Must have the ability to analyze the effectiveness of training, develop and implement action plans to address ongoing training opportunities.

  • Requires the ability to travel as needed.

Licenses and Certifications

  • Nursing\RN - Registered Nurse - State Licensure And/Or Compact State Licensure RN licensed to practice in Louisiana is required

ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS

  • Develops, implements and continuously improves a well-documented Medical Management orientation and role-based training program and is responsible for coordinating medical management staff training, including but not limited to specialists, nurses and physicians on an ongoing basis.

  • Provides feedback on employee’s progress throughout the training process and audits performance of new hires and/or new processes as necessary post training and reports issues or concerns to the Director, Manager or Supervisors on individual employee or team performance.

  • Supports designated Quality Audit processes to identify training needs and works closely with managers to implement training programs to address areas of opportunity.

  • Regularly provides communication and feedback to manager on care management programs and training departmental policies and procedures

  • Functions as a project coordinator for special care management projects as determined by management and performs additional job-related duties as assigned by manager. Supports the formation of collaborative medical management teams for various initiatives.

  • Works closely with operations areas to assure Sales Marketing, Claim, Customer Service, Network Administration, Legal and Membership Billing have an accurate understanding of interrelated processes and Medical Management programs and services.

  • Works closely with Medical Informatics, Sales Marketing, and other members of Medical Management to assure clients understand the value of services offered by Medical Management and BCBSLA to improve the health status of employees. This includes request and review of client specific reports, RFP responses, and the development of client presentations.

Additional Accountabilities and Essential Functions

The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions

  • Perform other job-related duties as assigned, within your scope of responsibilities.

  • Job duties are performed in a normal and clean office environment with normal noise levels.

  • Work is predominately done while standing or sitting.

  • The ability to comprehend, document, calculate, visualize, and analyze are required.

#LI_JH1

An Equal Opportunity Employer

All BCBSLA EMPLOYEES please apply through Workday Careers.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.

If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.

In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.

Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.

Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.

JOB CATEGORY: Insurance

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