We are seeking two Behavioral Health Case Managers to support members utilizing Applied Behavior Analysis (ABA) services within our BlueCare Behavioral Health team. These new positions will play a key role in addressing rising utilization and costs while ensuring members continue to receive high‑quality, appropriate care. Case Managers will work directly with members, families, and providers to guide care coordination, promote effective alternatives, and support transitions for youth receiving ABA services.

Key Responsibilities

• Engage with members, families, and providers to support appropriate use of ABA services
• Reduce reliance on high‑cost interventions while maintaining quality and continuity of care
• Coordinate care, identify alternative interventions, and facilitate provider collaboration
• Support family engagement and transition planning for a subset of youth
• Navigate the Behavior Analyst Service process and ABA Medicaid benefit requirements
• Assist members diagnosed with Intellectual Disability or Autism who present with safety risks, behavioral disruptions, or barriers to learning

Ideal Candidate Preferences

(Not required, but highly valued)

• Experience with Intellectual/Developmental Disabilities (IDD) or Autism service systems
• Strong Motivational Interviewing or Trauma‑Informed Care skills
• Prior remote or telephonic case management experience
• Familiarity with managed care, utilization management, or insurance processes

*Sponsorship is not available for this role. 

Job Responsibilities

• Supporting utilization management functions for more complex and non-routine cases as needed.
• Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs.
• Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits.
• Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation.
• Perform case management activities in community settings including face to face with members as required.
• Various immunizations and/or associated medical tests may be required for this position.
• Testing/Assessments will be required for Digital positions.

Job Qualifications

License

• Current, active unrestricted Tennessee license in Nursing (RN) or behavioral health field (Master's level or above) (Ph.D., LCSW/LMSW, LLP, MHC, LPC, etc.) required. RN may hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.

Experience

• 3 years - Clinical behavioral health / substance use disorder experience required
• 1 year - Must be knowledgeable about community care resources and levels of behavioral health care available.

Skills\Certifications

• Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
• Independent, Sound decision-making and problem-solving skills
• Excellent oral and written communication skills
• Strong interpersonal and organizational skills
• Strong analytical skills
• Positive relationship building skills and ability to engage and motivate health behaviors in diverse populations
• Ability to quickly identify and prioritize member needs and provide structured and focused support and interventions
• Experience with Motivational Interviewing Techniques and Adult Learning Styles

Number of Openings Available

1

Worker Type:

Employee

Company:

VSHP Volunteer State Health Plan, Inc

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

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BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.