Episodic Care Manager - Behavioral Health Autism Services

1 month ago
United States$73k–117kFull TimeGeneral Medicine

Job Description

About the Role

Join Blue Cross and Blue Shield of North Carolina as a Episodic Care Manager - Behavioral Health Autism Services in United States.

Key Responsibilities

  • Clinical Evaluation and Review Receive assigned cases for varied member services (i.
  • inpatient, outpatient, DME).
  • Review and evaluate cases for medical necessity against medical policy,.

Requirements

  • Assess appropriateness for secondary case review by the Medical Director (MD) for denials and coordinate as needed.
  • May coordinate peer-to-peer review upon provider request when members’ health conditions do not meet guidelines.
  • What You Bring For Behavioral Health Autism services specific roles, BCBA licensure with a minimum of 3 years of clinical experience.

Benefits & Compensation

-, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

  • Based on annual corporate goal achievement and individual performance. $73,698.00
  • based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc. wd5. myworkdayjobs. com/en

Work Schedule

  • Full-time position.
  • No explicit call, weekend, or night shift information provided.

Apply to join Blue Cross and Blue Shield of North Carolina as a Episodic Care Manager - Behavioral Health Autism Services.

Key Skills

Clinical ReviewsMedical Necessity AssessmentContractual Benefits InterpretationCare CoordinationUtilization ManagementMedical Policy ReviewRegulatory ComplianceMedical Director CollaborationClinical DocumentationBCBA LicensureClinical Experience
HealthcareSocial Servicesvia Workday

Position Insights

Work-Life Balance Analysis

WeekdayDoc's proprietary algorithm rates Episodic Care Manager - Behavioral Health Autism Services at Blue Cross and Blue Shield of North Carolina a 4.0 out of 10 for work-life balance — classified as below average. This places the position in the average range of all General Medicine physician listings evaluated on our platform.

Candidates should carefully assess workload expectations and scheduling demands before applying.

General Medicine — Physician Career Context

This General Medicine position at Blue Cross and Blue Shield of North Carolina is open to physician candidates.

Physicians (MD/DO) are in high demand across healthcare settings, with growing interest in positions that offer sustainable schedules and reduced administrative burden.

Compensation Analysis

Blue Cross and Blue Shield of North Carolina lists compensation for this physician position at $74k to $118k annually.

Location & Logistics

This position is based in United States.

Skills, Responsibilities & Benefits

Key skills and qualifications: Clinical Reviews, Medical Necessity Assessment, Contractual Benefits Interpretation, Care Coordination, Utilization Management, Medical Policy Review, Regulatory Compliance, Medical Director Collaboration. Candidates with experience in these areas may be especially well-suited for this General Medicine role.

Core responsibilities: The Episodic Care Manager performs clinical reviews to assess, facilitate, and coordinate healthcare services for members based on medical necessity and benefits, ensuring high-quality and cost-effective care delivery across the system. This involves evaluating cases against medical policy, providin...

Benefits package: Medical, Dental, Vision, Parental leave, Adoption assistance, Surrogacy assistance, Career development programs, Tuition reimbursement. A comprehensive benefits package is an important factor in evaluating total compensation beyond base salary.

About WeekdayDoc

WeekdayDoc is the only healthcare job board that scores every position for burnout risk and work-life balance. Every listing includes a proprietary burnout score, transparent salary data when available, and lifestyle filters for no-call, no-weekends, and remote positions. Browse more General Medicine physician jobs on WeekdayDoc to compare work-life balance scores and compensation across employers.

Blue Cross and Blue Shield of North Carolina logo

About Blue Cross and Blue Shield of North Carolina

Insurance
Durham, NC
2-5

Benefits & Perks

Medical
Dental
Vision
Parental leave
Adoption assistance
Surrogacy assistance
Career development programs
Tuition reimbursement
4.0

Work-Life Balance Score

Below Average

Job Details

Employment Type

Full Time

Posted

1mo ago

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