Case Management Manager, Blue Shield of California, Rancho Cordova, CA
Posted on November 4th, 2016
Case Management Manager
There's never been a better time to join Blue Shield!
Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California is focused on transforming health care by making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 3.5 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than $325 million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution.
We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.
Job Details
Working with a clinical and non-clinical team that support members with complex need cases to promote the delivery of quality services. The non-clinical team members support the care management team to outreach and engage members that may be in need of support. Additionally oversight includes clinical case managers supporting members with complex conditions.
Responsibilities:
Establishes operational objectives for department or functional area and participates with other managers to establish group objectives. Leads team through effective change management process for successful completion of goals. Responsible for team, department or functional area results in terms of planning, cost and methods. Ensures work flow procedures and guidelines are clearly documented and communicated. Interprets or may initiate changes in guidelines/policies/procedures. May lead special projects/committees/task forces.
Job Required Education/Experience
Generally requires Bachelor's degree or equivalent work experience and thorough experience in Nursing, Health Care Administration or related field (5+ years).
Active California RN license.
Directs and controls the activities of one or more smaller/less complex department(s) or functional area(s) through subordinate supervisors/team leads. Has full management responsibility for staff (i.e. salary actions, promotions, performance reviews, and disciplinary matters) in accordance with the organization's policies and applicable laws. Monitors on-going performance and communicates expectations and results. Provides developmental and training opportunities for team members. Identifies staffing needs and objectives. Strong supervisory/management, communication and negotiation skills and experience required. Comprehensive knowledge of case management, discharge planning, utilization management and community resources. Transplant and call center experience a plus. Able to operate PC-based software programs including proficiency in Word and Excel.
Job Additional Education/Experience
1.) Position oversees complex needs CM area as well as initial member outreach & engagement staff in a call center-type setting.
2.) Health Plan/Case Management managed care experience required.
For immediate consideration, please apply at: https://sjobs.brassring.com/TGnewUI/Search/Home/Home?partnerid=25386&siteid=5192