Manager, Behavioral Health Case Management

🕒 vor 1 Tag

🏈 Alabama, Arizona, +23 weitere Bundesländer – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🦀 Maryland – Remote 🚗 Michigan – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote ⚔️ Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $107.901 - $172.642 / Jahr

⏰ Vollzeit

🟠 Senior

🔴 Experte

👔 Manager

Jetzt Bewerben

Ähnliche Remote-Jobs finden

E-Mail-Benachrichtigung für neue Jobs einrichten

📊 Überprüfen Sie Ihre Lebenslauf-Bewertung für diese Stelle

Verbessern Sie Ihre Chancen auf ein Vorstellungsgespräch, indem Sie Ihre Lebenslauf-Bewertung vor der Bewerbung überprüfen.

Lebenslauf hochladen

Blue Cross NC

WebsiteLinkedInAlle Stellen

5001 - 10000 Mitarbeiter

Gegründet 1933

🏥 Gesundheitswesen

🛡️ Versicherung

⚕️ Krankenversicherung

Healthcare • Insurance • Healthcare Insurance

Blue Cross NC ist ein Krankenversicherungsanbieter, der eine Vielzahl von Gesundheitsplänen und -diensten für Einzelpersonen und Gruppen anbietet. Das Unternehmen konzentriert sich darauf, Qualitäts-Gesundheitsversorgung bereitzustellen und die Gesundheitsergebnisse für seine Mitglieder durch innovative Gesundheitsprogramme und -dienste zu verbessern. Blue Cross NC hat sich verpflichtet, den Zugang zu erschwinglicher Gesundheitsversorgung zu verbessern und gleichzeitig die Gesundheit und das Wohlbefinden der Gemeinschaften, denen es dient, zu unterstützen.

Beschreibung

• Assist in developing operational strategies and innovative solutions for areas of clinical oversight • Use competitive intelligence to guide strategic program and product development and management • Manage operational performance of multiple integrated clinical functions across lines of business • Initiate and manage service initiatives and programs promoting quality, cost-effective outcomes • Collaborate with internal and external customers to deliver an integrated care delivery model and seamless member experience • Investigate escalated or high-profile cases, troubleshoot issues, and guide staff toward resolutions • Present analyzed cases requiring high administrative approval or intervention • Establish and monitor performance, production, process, outcome, and financial metrics and goals • Manage or support departmental, divisional, and corporate projects affecting clinical services • Evaluate and manage vendor and partnership opportunities • Oversee or participate in relevant internal and cross-functional committees • Implement continuous quality improvement and change processes • Oversee regulatory and accreditation activities, compliance, and execution • Serve as primary contact for compliance and regulatory audits • Communicate programs and operational changes to internal and external stakeholders

🎯 Anforderungen

• Bachelor’s degree and 8+ years of relevant experience • If no degree, at least 10 years of relevant experience • For Behavioral Health specific roles, applicable licensure such as LMSW, LCSW, LPC, or LMFT will be considered • Valid NC license or multistate compact license preferred • 3+ years of direct supervisory or leadership experience preferred • Experience in population health, care management, clinical review or coding, or utilization management in a health care organization/system or health insurance preferred • Knowledge of managed health care organizations, governmental regulations, and applicable state and federal regulations • Experience with regulatory and accreditation activities, including ERISA, DOI, NCQA, and CMS • Ability to manage clinical and non-clinical teams and staff • Ability to establish and monitor operational, process, outcome, and financial metrics • Authorization to work in the United States

🏖️ Vorteile

• The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community • Work-life balance, flexibility, and the autonomy to do great work • Medical, dental, and vision coverage along with numerous health and wellness programs • Parental leave and support plus adoption and surrogacy assistance • Career development programs and tuition reimbursement for continued education • 401k match including an annual company contribution • Annual Incentive Bonus • Paid Time Off (PTO) • Competitive health benefits and wellness programs • Reasonable accommodations to applicants with disabilities