Case Manager, RN

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. 

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.  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.  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.

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.