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Case Manager (Remote)

Bellingham, WA

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. 


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!

     

Offering full and part time opportunities. Part time consists of 0.5 FTE schedule, 20 hours per week.

 

Who we are

Under the umbrella of Integrated Health Management, we are a member facing team of interdisciplinary trained clinicians including registered nurses, licensed behavioral health clinicians, dieticians and support staff providing case management, care transition management and other specialized services.

 

Who we serve

We provide a wholistic care model which involves collaboration with members and their families, caregivers, employer groups and providers. Case Managers use an integrated (physical/mental health) case management model, and a collaborative, relationship-based approach, including members, health care providers and caregivers to assist poly-chronic and high-risk members to improve their health outcomes. Case managers provide a comprehensive, integrated health assessment of member's current situation and status; identify actionable barriers and obtainable goals to achieve optimal self-care management; monitor member's progress toward goals; facilitate the coordination, communication and collaboration among the member's providers; advocate for members and promote self-advocacy; assist members to obtain appropriate quality care within their benefit plan; and identify resources in the community or within the member's natural support system to fill any gaps within their benefit plan.

 

Our teams use Motivational Interviewing (MI) techniques a method which involves asking thoughtful, purposeful questions. Motivational Interviewing helps to both engage and empower the member which can help fuel personal motivation and build the confidence needed to pursue change.

 

What you will do:

  • Engage members with medical, mental health and/or substance utilization disorders in services utilizing evidenced-based engagement skills.
  • Conduct initial holistic health assessment of member's current conditions, situation and needs and ongoing evaluations. Assessment may include an evaluation of the caregiver's needs as well as an evaluation of the larger system.
  • Collaborate with the member, caregivers and providers to develop a culturally sensitive case management plan that addresses barriers and promotes improved health outcomes.
  • Monitor and evaluate the effectiveness of the member's case management plan and continuously update to ensure goals are progressing and remain pertinent; identify and address barriers to completing goals.
  • Facilitate communication and coordination among the health care team to minimize fragmentation, eliminate duplication and maximize delivery of appropriate care.
  • Provide interventions focused on removing the member's barriers to health improvement; promoting positive behavior change using motivational interviewing techniques; and addressing the caregiver's needs in order to stabilize the member's natural support system.
  • Maintain concise, accurate and timely documentation that supports effective, efficient management of the member and that meets accreditation, contractual and legal requirements.

Job Requirements

What you will bring:

  • Registered nurse
  • Current state credential (e.g. licensure) to practice as a Nurse (e.g. RN, ARNP, LPN)
  • Have Certified Case Manager (CCM) certification or obtain certification within 24 months of hire
  • 3 years' experience with direct patient/clinical care.

Preferred experience:

  • Prior experience as a Case Manager
  • Integrated Case Management certificate (ICM)
  • Chemical Dependency Professional (CDP).
  • 6 years' clinical experience with patients.
  • Motivational interviewing experience.
  • Chronic Care Professional certification (CCP)
  • Registered Health Coach II or III

 

Training

Premera provides extensive training including initial and ongoing motivational interviewing skill development and assists personal health support clinicians and team leads in earning their Chronic Care Professional (CCP) certificate, Integrated Case Manager (ICM) certificate as well as their Certified Case Manager (CCM) credential. Premera is NCQA accredited program earning full credit for our case management program for the past two audits. As such, all our clinicians receive documentation, assessment and intervention skill training to ensure they are practicing at highest professional skill level. Clinicians and team leads also receive LEAN training that supports their active involvement in process improvement activities.

 

Perks

  • Premera paid licensure renewal
  • Supported work life balance
  • Collegial environment
  • Peer industry expertise

 

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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.

About Premera Blue Cross

At Premera, we make healthcare work better. By focusing on improving our customers’ experience purposefully and serving their needs passionately, we make the process easier, less costly, and more positive. Through empathy and advocacy, we change lives. As the leading health plan in the Pacific Northwest, we provide comprehensive health benefits and services to more than 2 million customers, from individuals to Fortune 100 companies. Our services include innovative programs focused on health management, wellness, prevention, and patient safety. We deliver these programs through health, life, vision, dental, disability, and other related products and services.



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.

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