Case Manager

Premera; Washington (District of Columbia); Remote; USD 78,000 - 123,000; Full time

Job summary

An established industry player in healthcare is seeking compassionate Case Managers to join their dedicated team. This role offers the unique opportunity to engage with members facing various health challenges, providing holistic support and guidance towards healthier lifestyles. You will conduct assessments, develop personalized care plans, and facilitate communication among healthcare teams. With extensive training and a supportive environment, you will thrive in your career while making a meaningful impact on the lives of others. If you are passionate about improving healthcare and want to contribute to transformative change, this is the perfect opportunity for you.

Benefits

Extensive training programs

Support for certifications

Paid licensure renewal

Reimbursement for exam fees

Paid membership in professional organizations

Qualifications

• Must have a current RN license and 3 years of clinical experience.
• Experience with case management and motivational interviewing preferred.

Responsibilities

• Engage with members facing health challenges to support their needs.
• Conduct holistic assessments and develop member-centric care plans.
• Monitor and update case management plans to ensure goal progress.

Skills

Registered Nurse (RN)

Motivational Interviewing

Case Management

Holistic Health Assessment

Communication Skills

Education

Bachelor's Degree in Nursing

Tools

Healthcare Management Software

Job description

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.

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.

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 [e-mail] 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: $78,000.00 - $122,200.00

National Plus Salary Range: $81,900.00 - $139,200.00

*National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.

We’re happy to discuss compensation further during the interview because we believe that open communication leads to better outcomes for all. We’re committed to creating an environment where all employees are celebrated for their unique skills and contributions.