Sr. Manager, Care Management Nurse Management (Commercial)

Blue Shield of CA; Rancho Cordova (CA); Hybrid; USD 120,000 - 180,000; Full time

Job summary

Blue Shield of CA is seeking a Senior Manager of Care Management to lead and oversee the team, ensuring effective coordination of patient care across multiple settings. You will report to the Director of Care Management and drive optimization of care management programs for high-quality, cost-effective member care.

The role emphasizes developing leaders at all levels, fostering critical thinking, and building high-performing teams, with a hybrid in-office/remote work model and opportunities for

Qualifications

• Bachelor of Science in Nursing or advanced degree preferred.
• Current CA RN license.
• CCM certification or in process when eligible based on CCM requirements.
• Ten+ years of healthcare experience with at least 4 years in management.
• 3+ years in care management for a health insurance plan or managed care environment preferred.
• 3+ years supervising staff, budgeting, program planning.

Responsibilities

• Lead and oversee the Care Management team to coordinate patient care across settings.
• Oversee and optimize care management programs to ensure high-quality, cost-effective care.
• Foster leadership development and continuous learning across the team.

Skills

Leadership

Communication

Analytical skills

Time management

Interpersonal skills

Budgeting

Cross-functional collaboration

Microsoft Excel

Project management

Education

Bachelor of Science in Nursing

Advanced degree (MSN or higher)

CA RN license

Tools

Microsoft Excel

Microsoft Office

Databases

Job description

Your Role

The Care Management team is looking for a leader who can lead and oversee our team to ensure the effective coordination of patient care across multiple settings. The Senior Manager of Care Management will report to the Director of Care Management. In this role you will be responsible for overseeing and optimizing our care management programs to ensure high-quality, cost-effective care for our members. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Bachelor of Science in Nursing or advanced degree preferred.
• Current CA RN license.
• Certified Case Manager (CCM) or is in the process of completing certification when eligible based on CCM application requirements.
• Requires at least ten (10) years of prior experience in healthcare related field including 4 years of management experience.
• Three (3) years conducting Care Management for a health insurance plan or managed care environment preferred
• Proficient with Microsoft Excel, Outlook, Word, Power Point, and the ability to learn and utilize multiple systems/databases
• 3+ years of experience in an administrative management position in a health care setting preferred
• 3+ years of responsibility for the supervision of professional staff, budgeting, program planning and licensing preferred
• Familiarity with NCQA requirements
• Successful track record in building and maintaining positive cross-functional relationships
• Excellent analytical, communication skills, written skills, time management, and organizational skills
• Possess outstanding interpersonal, organizational, and communication skills, positive attitude, and high level of initiative

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.