Manager, Case Management

Premera Blue Cross•WA Western Telecommuter, WA

8d•$89,300 - $173,200•Remote

About The Position

The Manager, Case Management Team is a Supervisor for Case Managers. This position is responsible for the execution and implementation of Clinical Programs’ strategy and goals and the oversight of Clinical Programs’ operations. The incumbent oversees the effective integration and continuous improvement of processes and systems to meet Premera’s current and future business goals. Responsibilities also include managing and developing a team of clinical and support staff promoting their professional growth and operational effectiveness. This position aligns to PST business hours.

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)

Nice To Haves

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.

Responsibilities

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.

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 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.
Generous paid time off to reenergize.
Tuition assistance for both undergraduate and graduate degrees.
Employee recognition program to celebrate anniversaries, team accomplishments, and more.
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.
Challenge someone to a game of shuffleboard or ping pong while on campus.