How to get position at UnitedHealth Group/Blue Cross Blue shield

Specialties Case Management

Published

Hello :) How are you?

Well here's the thing. You must have had a job where you have done these things. In other words it was in your job description to do these things.

it appears that the op got it in his/her head to go to work for bcbs and sent them some kind of communication to that effect, but no cover letter or references, and has no experience in the kinds of work they have. this is not a functional way to obtain a position with a business.

bcbs is no place for beginners. they have zero interest in training newbies as case managers, disease managers, or utilization review people for their complex suite of insurance plans when there are plenty of people with applicable experience (including case management and good familiarity with insurance products) to be had.

your school probably has a placement/careers office. even if you have graduated long since, they will probably be able to help you with the mechanics of how to apply for work-- how to write a cover letter, resume, interview skills, etc. schools will usually do this for free, so don't waste money on companies that promise you the moon if you'll just follow their fool-proof schemes for getting the job of your dreams.

it appears that the op got it in his/her head to go to work for bcbs and sent them some kind of communication to that effect, but no cover letter or references, and has no experience in the kinds of work they have. this is not a functional way to obtain a position with a business.

bcbs is no place for beginners. they have zero interest in training newbies as case managers, disease managers, or utilization review people for their complex suite of insurance plans when there are plenty of people with applicable experience (including case management and good familiarity with insurance products) to be had.

your school probably has a placement/careers office. even if you have graduated long since, they will probably be able to help you with the mechanics of how to apply for work-- how to write a cover letter, resume, interview skills, etc. schools will usually do this for free, so don't waste money on companies that promise you the moon if you'll just follow their fool-proof schemes for getting the job of your dreams.

thank you for your help. you are right. :)

I'm currently employed by a large corporation in their benefits department. I do general office work for the most part. There are only four of us in the office. They hired me to help them translate medical jargon that sometimes comes up in the course of business. This only happens every now and then. For the most part I do filing,adress changes and enter figures into a spreadsheet. This is a far cry from my former job as a med nurse in a nursing home. If you get this type of job, be prepared to be bored. It's a great job. I'm home at five O'clock and have weekends off. It does get tedious though. I pass the time reading allnurses and several other sites I like.

You are lucky :) Can you please tell me how I can get a job like this. What company? Are they hiring. and what do i need to add to my resume to get a job there. Thank you. :)

Specializes in Vents, Telemetry, Home Care, Home infusion.

moved to our case management nursing forum for best advice.

I work for United Healthcare as care coordinator in TN. I'm surprised someone said BlueCross doesn't give much orientation. I got 5 weeks at United, and they continually do ongoing training.

It seems to me they do not hire very often. We NEED more people! Or we will be working even more than we already do....which is a LOT.

I think they are a good company to work for.

I have just accepted a telephonic case manangement position with one of the companies you mentioned.I had applied to the 2 you mentioned. One of the companies advertised in Nursing Spectrum an open RN Interview day- I went to that. The other was strickly an online application from a google search under case managment nursing position. Check out Unitied healthcare group, BlueCrossBlueSheild again, Aetna, Cigna any other major health care insurance companies. I got my new position by looking on their web site for a position they posted in my area. I was very leary because the location is a high crime big city. But I felt there was no harm in applying - all I could get was a rejection email letter and It's not like I haven't got them before. I was afraid it would be home visits in dangerous neighborhood. But it is all telephone.

I have 30 years RN experience. Most of which-29 years is acute care bedside hospital- med/surg/oncology(18 yrs) tele/cardiac stepdown medical and surgical(7years) 2 yrs ambulatory care- outpatient smaeday surg and 1 year clinic which includes telephone triage and telephonic nursing consultation. I wrote my resume to talor my clinic telephonic experience to how it relates to case manangment of the patients. I have taken some coursework as 1 day seminars in case managment and UM(nursing spectrum also offers some big CEU courses in both case managment and UM) They helped get my mind gearing toward how nurses in bedside actually are doing case managment but on a short term basis- you are managing the patients you are assigned to in those beds.(you are monitoring their physical condition, their labs, their meds, how they are responding to these meds/course of treatment and do they still belong on your unit - are they sicker or do they need to be discharged home, with or without a HHnurse or to a rehab, their educational needs for self care, DME needs)

I was called by this company after online applying for an interview. And offered the job within one week of the interview. It appears these 2 companies- and there are 2 more who have been asked by the states they offer insurance in, to offer medicaid plans- going along with the healthcare reform agenda. These companies have been offered contracts by the states to oversee the medicaid insurance needs of the underinsured and uninsured population which there are millions of qualifying people, alot of whom are those who have lost their jobs and lost their employer healthcare plan. For me, this issue of hopsital CEO's making big bucks and people with no jobs and no insure , this is a good fit for me. It's all I can do to be proactive and participate in it's solution. If I had the authority to fire these hospital CEO's or at least cut their salaries to a more reasonable levelin tune with the current economic times. I would in a heartbeat.( which is what needs to be done badly/long overdue and hopefully is the next step) I participated in a healthfair with fellow nurses at a commercial business industry convention and saw people who were once employed(self imployed, small business owers) unemployed/working class people who have no insurance and who brough their young children(also without insurance) to this convention. If I didn't know better - It looked like a sene from the Great Depression of the 1920's-1930's. I have worked in a hospital for 3 years an inner city "getto hospital" and saw the sickest of sick- again no insurance and not seeking care until the disease was so advanced it was ICU time.

My advise is to read some of those CEU articles and think about how you case managed those med/surg and LTC patients and keep applying. These companies are having RN interview days and will continue to have because of the millions who will be getting the lower cost insurance if and when they can afford it. Right now, these case managment positions are only for RN's with experience which you posted- you have. Try re writing some of the job responsiblities of you work experience tailoring it to the case mangement mind set. Don't present your experience as a med surg or LTC mindset- just walking in and out of rooms to patients, doing assessments, giving meds- task oriented.

I might add, I am nervous as 'all get out' to be starting this new job- as I have never worked in the corporate business insurance world (not a scrubs job), and I love the co-workers and the work I will be leaving at the clinic.

Good luck to you.

I would suggest doing home health for a few years before transitioning into this type of position. I just got a job with a similar company with 2+ years of HH. You'll learn case management as well as the insurance woes. Good Luck!

Specializes in L&D; Case Management; Nursing Education.
bcbs is no place for beginners. they have zero interest in training newbies as case managers, disease managers, or utilization review people for their complex suite of insurance plans when there are plenty of people with applicable experience (including case management and good familiarity with insurance products) to be had.

i don't think this is necessarily true. i had no experience in cm, dm, or um when i answered an ad for a case manager. i did have 16 yrs of clinical nursing experience, but nothing in insurance or business. i was trained on-site for 6 wks, then began working at home. i've done cm, dm, and um from home for 5 yrs now and last year got my ccm certification. so, there are some companies that are willing to train "newbies."

i would suggest using a cover letter, though, no matter what type of job you apply for. this is expected of a professional. even if you apply online, there is usually a way to upload a resume and cover letter. i do not include references on my resume, but write "references upon request." on an online application, though, i do list my references if they ask. best luck finding the position you want.

beachyfe- I have accepted a position as a home based CM for an insurance co. How do you like working at home? Can you give me any info on the pros/cons of working from home. I do not have any young children at home so distraction is not an issue. I am still undecided about leaving my current position, which I like and I like my co-workers. I am also feeling that if I turn this position down, there will not be any more chance of getting another like this and that for an older experienced RN- this is where all my nursing peers are and this is the only place for us where we are accepted and respected for our experience.. All I have seen of the insurance nurse CM is the video on the company's web site, which is only going to give the positives about the position. This would be my first venture into work from home, CM, UM and DM. I want to get out of clinical nursing, no more hospital bedside for me(after 30+years) but I am so afraid to take the leap. My current position is temporary. The insurance co is permanent- no probation period but 3 months orientation. The clinic position is approx some(20%) face to face clinical, mostly telephonic- med refils, referrals and sx based(sending pt's to ED, urgentcare, or doctor's appt's) in a clinic but not CM/UM/DM. The patient population at the clinic is "extremely" demanding and get their way even if it's against provider better judgement.

I have accepted the position in the insurance co as a CM, will be from home, no home visits but am still on the fence about it. I have not quit my clinic position yet. I talked to another older nurse, who has never worked telephone CM but told me- it's quota's each month???? This has kind of scared me off. I was told at the interview I would have a case load of 100 patients/month of complex medical patients, some will need every 2 week reviews.

Any thoughts on what I'm in for?? Thanks

Hello,

I too tried and tried to get into BCBS for pre certification and discharge planning. Are you in Michigan? If so, try one of the agency's they will get you in on the 24/7 nurse line or the quit smoking program and if your lucky they will hire you permenately, once that happens you can apply for other positions internally. Agency's to try A-Line staffing solutions and Aerotek Scientific. I have seen postings for other agency's in other states so if you are not in Michigan try agency's in your state. Beware, pay is awful, I am making $6 less per hour than my last job and as a contracter there is no shift diff or weekend diff, you are expected to work holidays for no extra compensation, weekends are not every other-- some people work three in a row others work only one, its 10 hour shifts which sound great, but you never get three days off in a row. From Sept. 9th -15th I worked 60 hours with 1 day off, this is because pay period ended on Sat. the 10th. Its rough, but if you want to get your foot in the door without CM experience this is the only way I know of. Scheduling is done very poorly, requests were to be in 2 weeks ago NO EXCEPTIONS! and the schedule is yet to be seen, with only 10 days left on the current schedule; not that it matters because when it does come out it could very possibly change! I get the impression that management could care less if you have a life, or children, but they all know what their schedules are. I know all of this sounds bad, but I am not used to being treated this way, coming from a hospital setting where you are compensated for your off shift, weekend and holiday time and where managers have a brain in there head and don't schedule the afternoon nurses to work every single friday on the schedule. On the up side, if you manage to get hired as a BCBS employee they do pay weekend diff and holiday pay and if you can get off the 24/7 line it will be mon-fri with no holidays and they have a lot of holidays, like "black friday". The job itself is not bad, you just have to decide if you can put up with the above to get your foot in the door, no guarantees. For me, I'm looking for another job, I don't have time to wait around while they decide on hiring and the schedule is hell on my kids. Hope this helps, good luck!!:nurse:

Specializes in L&D; Case Management; Nursing Education.
how do you like working at home? i love working from home, but you have to be very self motivated. no supervisor looking over your shoulder or others to see what you're doing. but if you're a self-starter, then it's a dream come true. i can wake up at 8:15am and log in to the computer at my starting time of 8:30am. eventually i get dressed, cleaned up, and have breakfast. :p can you give me any info on the pros/cons of working from home. for me, the best part of being at home is not having to drive to and from work (especially in bad weather). even if i might have to work longer than my shift (which happens often), i think about how i would have spent an extra 1.5 hrs driving everyday, so it doesn't seem to be a big deal to work a little over. some people don't like being alone all day - personally i don't mind (i'm talking on the phone to patients all day long) and i actually enjoy not being in a gossipy group of women. i can turn the radio to whatever music i like and throw a load of laundry in when needed. this is the only place for us where we are accepted and respected for our experience. this is somewhat true - no one is judging you by how you look. i have accepted the position in the insurance co as a cm, will be from home, no home visits but am still on the fence about it. i have not quit my clinic position yet. i talked to another older nurse, who has never worked telephone cm but told me- it's quota's each month???? this has kind of scared me off. i was told at the interview i would have a case load of 100 patients/month of complex medical patients, some will need every 2 week reviews. it's true that your productivity is based on the amount of time you spend working a case. it's called "billable hours", just like an attorney. if you think about it, how else can your company make sure you're actually doing a full day's work rather than sitting around watching tv or messing around on facebook?? so, when you contact your patient, talk to them, then document it all on the computer chart, you bill for the time it took you - but only for as much time as the company allows. basically, you have to work pretty fast and are expected to do alot. we have to have 80% of our workday as billable hours-->so if you work 8 hrs a day, then you must get at least 6.4 billable hours per day. keeping this up is part of your evaluation. my caseload is also 100 patients. it's alot and will keep you very busy; i probably call 15-20 patients a day, do their documentation, and do auths/certifications for hospital stays. btw, everything you do is recorded and can be seen by management. they record (and listen to) all your phone calls and keep a close eye on your charts, daily patient call list, billable hours, amount of activities you complete each day, etc. again, this is so they can be sure all their remote employees are really working. i used to get frustrated with not being able to spend as much time as i'd like talking with a patient, but you just can't or you'll get too far behind. not much different than any other type of nursing job, though, is it? despite all this, i think the pros outweigh the cons. oh, be sure you do some daily exercise or you'll end up with a "chair butt" from sitting still 8 hrs a day.

any thoughts on what i'm in for?? thanks

i did 2 months of training and it took between 1-2 yrs before i really felt like an "expert" at the job. it was a big learning curve because this is all about business and insurance. a totally different ballgame from nursing. but i learned it and also got my certification in case management (ccm) last year. i've learned a whole new field and widened my opportunities. good luck - hope you like it.

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