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Premera Blue Cross

Health benefits plans and related services

Case Manager - RN

Medical, Clinical & VeterinaryPosted on Nov 13
Full-timeRemote in USARemote

About the Job

Requirements

  • An active Washington State or Compact Registered Nurse or Advanced Registered Nurse Practitioner license that permits independent assessment is required.
  • Three years of post-licensure direct-care experience are required.
  • One year of post-licensure case-management experience involving care coordination, care planning, discharge planning, or management of patient care over time is required.
  • Applicants residing outside Washington must have or obtain the appropriate Washington State license and apply within 10 days of acceptance.
  • Applicants must have internet access through any internet service provider with a minimum download speed of 75 Mbps.

Responsibilities

  • Engage members facing medical utilization disorders and build relationships that support open and constructive dialogue on sensitive topics.
  • Conduct initial holistic health assessments to understand each member’s situation and needs, and identify social determinants of health and cultural influences that may affect lifestyle changes.
  • Collaborate with members, relevant caregivers, and providers to develop member-centric case-management plans that set goals, address potential barriers, and improve health outcomes.
  • Monitor, evaluate, and update case-management plans to track progress toward goals and ensure goals remain pertinent.
  • Facilitate communication and coordination among the healthcare team to maximize appropriate care delivery.
  • Provide interventions to remove barriers, promote positive behavior change using motivational interviewing techniques, and stabilize members’ natural support systems by identifying and meeting caregiver needs.
  • Maintain concise, accurate, and timely documentation that meets accreditation, contractual, and legal requirements.

Desired Qualifications

  • Certified Case Manager certification is preferred; applicants without it at hire must obtain it within 24 months of hire.
  • A bachelor's or master's degree is preferred.
  • Four or more years of direct-care experience across multiple patient populations, conditions, or care settings are preferred.
  • Motivational interviewing experience is preferred.
  • Chronic condition certifications in asthma, cardiology, diabetes, high-risk maternity, oncology, or pediatrics are preferred.
  • Integrated Case Management certificate is preferred.
  • Chemical Dependency Professional certification is preferred.
  • LEAN training is preferred.

About the Company

Premera Blue Cross

Health benefits plans and related services

Premera Blue Cross is a regional health plan based in Mountlake Terrace, Washington, serving more than 2.8 million people in Alaska and Washington. It provides comprehensive health benefits and a wide range of related services, including health, life, vision, dental, stop-loss, disability, and workforce wellness offerings. Its products are delivered through employer groups, individuals, and other customers, with a focus on tailored services, quality outcomes, and cost control to make healthcare work better for customers. Premera differentiates itself by operating as an Independent Licensee of the Blue Cross Blue Shield Association in its Pacific Northwest footprint, offering a broad benefits portfolio and services such as language assistance and accessible support to meet civil rights and customer needs. The company’s goal is to improve customers’ lives by making healthcare easier to access, understand, and manage, while maintaining affordable, quality care.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Mountlake Terrace, WA
Founded
1933

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