Manager, Case Management

🔥 0 minutes ago

🐻 Alaska, Arizona, +25 more states – Remote

🐻 Alaska – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🐊 Florida – Remote 🥔 Idaho – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🌲 North Carolina – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🏰 Missouri – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote ☕ Washington – Remote 🧀 Wisconsin – Remote

💵 $89.3k - $151.8k / 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

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

• Participate in development of Clinical Programs’ strategy and planning in accordance with company's mission and strategic goals, federal and state law and regulations, and accreditation standards. • Assist in the selection, training, evaluation, and development of professional paraprofessional, and administrative team members. • Lead Care Management teams in effective performance of job functions, which may include case management and delegated management oversight. • Participate in the development and monitoring of budgets in accordance with department and organizational objectives. • Participate in the development, implementation, and monitoring of the department's performance standards, utilizing quality improvement methodologies to refine procedures. • Foster collaborative work environment that encourages team building, facilitates cohesive synergetic performance of Case Management functions, while valuing the individual diversity and uniqueness of all employees. • Build and maintain cooperative business relationships. • Participate in activities and processes to ensure operational compliance with regulatory requirements, including NCQA and OIC. • Provide effective oversight and developmental support for team members to meet productivity and satisfy expectations. • Facilitate team building across the team so that team members feel connected to one another and the larger department. • Effectively manages deficits with improvement plans and consistent follow-up. • Use data effectively to monitor performance, identify opportunities and address problems and opportunities timely.

🎯 Requirements

• Candidates with a RN License are highly preferred. • Current state credential (e.g. licensure) that allows the professional to conduct an assessment independently as permitted within the discipline's scope of practice (Required) : • For nurses, required registration (e.g. RN, ARNP). • For behavioral health, required licensure (e.g. LMFT, LICSW, LPC, LMHC) • For psychologist, required board certification • For dietitians, required certification as a nutritionist or dietician • Or licensure in related healthcare discipline • Certified in CCM (Certified Case Management) or obtain certification within 24 months of date of hire. (Required) • Five (5) years case management or health care experience. (Required) • Three (3) years management experience. (Required) • Advanced degree such as Master's Degree in a Health-Related field preferred. • Experience with NCQA, URAC, or accreditation review processes. • Experience in continuous process improvement and creative problem solving (e.g. LEAN, Synectic). • Advanced training in Motivational Interviewing. • Experience training clinical and non-clinical staff. • Experience managing case management teams and integrated case management model.

🏖️ 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. • Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees. • Employee recognition program to celebrate anniversaries, team accomplishments, and more. • For our hybrid employees, our 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. • Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more. • Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling. • Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus.