Case Manager

Blue Cross Blue Shield Association • Full-time • Remote (US) • $70.10k - $135.80k / year • 3m ago

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.

To better serve our customers, we’re creating a culture that promotes employee growth, collaborative innovation, and inspired leadership. We are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives! As a result of these efforts we are proud to share that

Forbes ranked Premera among America’s 2023 Best Midsize Employers

and

America's 2023 Best Employers By State

Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog:

https://healthsource.premera.com

Case Managers are a dedicated team of clinicians (RNs, behavioral health professionals, and dieticians) who utilize a holistic model that enables our members to transition towards healthier lifestyles.

Who we serve:

Premera Blue Cross, a nationally recognized leader in the practice of integrated case management, is looking to expand our growing team of Case Managers. Our comprehensive, whole-person health assessment helps to identify member actionable barriers and develop obtainable goals that will eventually lead to self-care. In the interim, case managers employ an integrated case management approach that recognizes making lifestyle changes is not simple and meets members where they are. We also monitor progress toward goals and facilitate the coordination of providers as needed. Our market-differentiated approach has helped thousands of members make meaningful improvements to their daily habits, health, and overall well-being.

What you will get in this role:

The opportunity to help members in a meaningful and impactful way. We know that helping people is important to you.

The opportunity to learn and grow. You will be working with folks who literally wrote the book on integrated case management.

The opportunity to have an impact. Your work improves the lives of our members and enables us to operate more impactfully.

The opportunity to thrive in a career. We offer a supportive and safe environment where clinicians can work to the top of their licensure.

The opportunity to take pride. We know your work is important just as you do.

What you will do:

Engage target members (those who are facing medical, mental health and/or substance 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.

What you will bring:

Required:

Registered Nurse – RN current state license that allows the professional to conduct an assessment independently as permitted within the discipline's scope of practice.

3 years' experience with direct patient/clinical care post-licensure.

High-speed cable, DSL, or Fiberoptic Internet, no less than 20 Mbps – Satellite and Wireless connections will not work with our equipment.)

Preferred:

Prior experience as a Case Manager and Certified Case Manager (CCM) certification

Chemical Dependency Professional (CDP)

Chronic Care Professional certification (CCP)

LEAN training

Advanced Motivational Interviewing skills

Licensing and Certification Expectations:

All Case Managers are required to have a valid WA state or MSL/ Compact license and meet WA state credentialing requirements.

Any Case Manager not holding an active Certified Case Manager (CCM) certification will have 24 months to obtain one.

Training and Perks:

Premera provides extensive training including initial and ongoing motivational interviewing skill development.

Support in earning your Chronic Care Professional (CCP) certificate, Integrated Case Manager (ICM) certificate, as well as your Certified Case Manager (CCM) credential.

Since 2012, Premera has been a NCQA accredited program earning full credit for our case management program. All our clinicians receive documentation, assessment, and intervention skill training to ensure they are practicing at the highest professional skill level.

Clinicians and managers also employ LEAN methodology that supports their active involvement in process improvement activities.

Paid licensure renewal

Reimbursement for CCM exam fees and renewal

Paid membership in the National Case Management Society of America (CMSA) and the local state chapters

Work Location and Schedule:

This position is classified as a telecommuter.

Training Schedule: Your training schedule for the first four to six weeks of hire will be Monday through Friday, between 8 am and 5 pm PT (Pacific Time)

Ongoing Schedule: You will be working a 40-hour weekly schedule that includes 5 hours that will provide coverage for extended hours (Monday through Friday between 5 and 7 pm or Saturday between 9 am and 2 pm. Note: all times are Pacific)

Please note: Schedules are subject to periodic change due to member coverage requirements.

What we offer

Medical, vision and dental coverage
Life and disability insurance
Retirement programs (401K employer match and pension plan)
Wellness incentives, onsite services, a discount program and more
Tuition assistance for undergraduate and graduate degrees
Generous Paid Time Off to reenergize
Free parking

Equal employment opportunity/affirmative action:

Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785.

Premera is hiring in the following states, with some limitations based on role or city: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.

National Salary Range:

$70,100.00 - $119,200.00

National Plus Salary Range:

$79,900.00 - $135,800.00