Case Manager, RN

🔥 1 minute ago

☕ Washington – Remote

☕ Washington – Remote

💵 $80.2k - $125.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Premera Blue Cross

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1945

⚕️ Healthcare Insurance

Healthcare Insurance

Premera Blue Cross is an independent health insurance provider, serving businesses and residents of Washington State and Alaska as a licensee of the Blue Cross Blue Shield Association. The company offers a range of health plans including individual, family, employer-based, and Medicare Supplement plans. However, it has announced that it will exit the Medicare Advantage market as of January 1, 2025. Premera is committed to advancing health equity and community support, evident through its Social Impact Program focused on behavioral health and homelessness solutions in Washington and Alaska. Additionally, Premera complies with federal and state civil rights laws, offering language assistance services to ensure equitable care.

📋 Description

• Engage members who are facing medical utilization disorders and build a relationship that will support open and constructive dialog on sensitive topics. • Conduct initial holistic health assessments that help build an understanding of a member’s specific situation and needs and identify any social determinants of health (SDOH) and cultural influences that may impact potential lifestyle changes. • Create a space where a case manager and member can collaborate, along with relevant caregivers and providers, to develop a member-centric case management plan that sets goals, addresses potential barriers, and leads to improved health outcomes. • Monitor, evaluate, and update the effectiveness of the member's case management plan to ensure progress toward goals is being made and that current goals remain pertinent. • Facilitate communication and coordination among the health care team to maximize delivery of appropriate care. • Provide interventions focused on removing barriers, promoting positive behavior change using motivational interviewing techniques, and stabilizing the members’ natural support systems by ensuring that caregiver needs are identified and being met. • Maintain concise, accurate, and timely documentation that meets accreditation, contractual, and legal requirements.

🎯 Requirements

• Active WA State or Compact RN or ARNP license that allows you to conduct an assessment independently. • 3 years' post licensure direct care experience. • 1 year of post-licensure case management experience involving care coordination, care planning, discharge planning, or management of patient care over time. • Certified Case Manager (CCM) certification preferred. • If applicants do not have their CCM certification at hire, then they are required to obtain within 24 months of hire. • Bachelor’s or Master’s degree preferred. • 4 or more years direct care experience across multiple patient populations, conditions, or care settings. • Motivational interviewing experience. • Chronic Condition Certifications (Asthma, Cardiology, Diabetes, High Risk Maternity, Oncology, Pediatrics). • Integrated Case Management certificate (ICM) preferred. • Chemical Dependency Professional (CDP) certification preferred. • LEAN training preferred. • Individuals residing outside Washington must have or obtain the appropriate Washington State license (apply within 10 days of acceptance). • Internet access through any Internet Service Provider (ISP) with a minimum connection speed of 75 Mbps (megabits per second) download speed.

🏖️ Benefits

• Medical, vision, and dental coverage with low employee premiums. • Voluntary benefit offerings, including pet insurance for paw parents. • Life and disability insurance. • Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service. • Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few. • Generous paid time off to reenergize. • Tuition assistance for both undergraduate and graduate degrees. • Employee recognition program to celebrate anniversaries, team accomplishments, and more. • On-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement. • Commuter perks make your trip to work less impactful on the environment and your wallet. • Free convenient on-site parking. • Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable. • Engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more. • Complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.