Manager, Case Management

Workforce Classification: Telecommuter Join Our Team: Do Meaningful Work and Improve People s Lives Our purpose, to improve customers lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare. Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we re able to better serve our customers. It s this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace. Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: . Please note this position aligns to PST business hours. 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. What you'll do: • 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. What You ll Bring: • 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. Premera total rewards Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including: • 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 yea...