R-49706 The Quality Improvement team at BCBST is seeking a Clinical Outreach Specialist – LPN to join the team! In this role, you will provide targeted telephonic outreach to members with positive preventive screening or diagnostic results. You will also apply clinical judgment to explain results, associated risks, and the importance of timely follow‑up, while addressing member questions and concerns within an established scope of practice. As a key clinical resource, you ‘ll reinforce provider‑recommended next steps, supports care navigation and Population Health referrals, and partner with internal teams and vendors to confirm follow‑up completion, address barriers, and ensure accurate documentation. This position supports HEDIS performance and quality improvement efforts and is ideal for an LPN experienced in:

• Leading proactive, preventive health outreach to engage and support member populations
• Educating members clearly and effectively on available health and wellness programs
• Diagnostic screenings to support early detection and coordinated care
• Using enterprise approved AI tools to support care coordination, decision making, and workflow efficiency

Note:

• This is a fully remote role, with the opportunity to volunteer at Community events.
• Sponsorship is not available for this role.

Job Responsibilities

• Conduct targeted outbound outreach to members with positive screening or diagnostic results following vendor notification.
• Apply LPN clinical judgment to explain test results, associated risks, and the importance of timely diagnostic follow-up.
• Address member questions and concerns requiring clinical interpretation, including anxiety related to results.
• Reinforce provider-recommended next steps without establishing or managing a plan of care. and refer members to Population Health Programs as appropriate.
• Confirm follow-up completion and assist with navigating barriers in collaboration with internal teams and vendors.
• Document outreach activities, member responses, and outcomes in designated systems and share trend insights with quality leadership.

Job Qualifications Licensure

• Active, unrestricted Licensed Practical Nurse (LPN) license

Experience

• 2 years - Experience in patient/member education, clinical follow-up, or care coordination
• HEDIS experience preferred

Skills\Certifications

• Knowledgeable of HEDIS measures, claims billing guidelines and health plan standards.
• Familiarity with preventive screening workflows and vendor supported outreach
• Strong communication skills with the ability to translate clinical concepts into member-friendly language
• Comfortable working with sensitive health information and high-risk scenarios
• Ability to explain screening and diagnostic results, associated risks, and follow‑up importance in clear, empathetic terms

Number of Openings Available 1 Worker Type: Employee Company: BCBST BlueCross BlueShield of Tennessee, 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. Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: 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.