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Manager, Care Management- HCCU Job

Date: Dec 28, 2018

Location: Eagan, Minnesota, US, 55122

Company: Blue Cross and Blue Shield of Minnesota

For more than 80 years, Blue Cross and Blue Shield of Minnesota has been passionate about improving health. We provide quality, cost-effective health plans and innovative programs that make a healthy difference in people’s lives. Blue Cross is the largest health plan based in Minnesota, covering nearly 3 million members in the state and across the country. We strive to help all Minnesotans overcome the barriers to good health.



 



We offer our employees a comprehensive benefits, compensation and total rewards package to keep you and your family healthy and to secure your financial future. Our Employee Resource Groups help us advance health equity while promoting a diverse and inclusive work environment. Join us and make a healthy difference in people’s lives through the work you do every day. Together, we'll make Minnesota a better place to live — and a healthier one.


Description Summary

This position is responsible for the day to day operational performance of an integrated health management team while ensuring high quality care management and adherence to regulatory and compliance standards for commercial and/or government program lines of business

Accountabilities


  1. Manages and leads the overall care management activities and day to day operations of the team includes aspects of budget. Evaluates policies and workflows for efficiencies, and makes necessary changes to diminish risk and enhance process improvements.

  2. Manages the design, development, implementation and maintenance of projects/process related to care management initiatives that may encompass multi departments.

  3. Coordinates the development, revision and implementation of care management policies and procedures. Assures consistency in processes and function across teams auditing and solid business practices.

  4. Assure compliance with state and federal regulations, accreditation requirements, contract agreements, and performance guarantees and participates and/or leads with on-site account and provider meetings.

  5. Coaches, mentors, and holds staff accountable to assure that department and performance goals and objectives are met.

  6. Ability to analyze data and recommend strategies for pilots, projects, and trends for care management initiatives.

  7. Manages the department including interviewing and hiring employees following required EEO and Affirmative Action guidelines and ensuring employees receive the proper training. Conducts performance evaluation, and is responsible for managing employees, including skill and career development, policy administration, coaching on performance management and behavior, employee relations and cost control.


Requirements


  • Current MN RN licensure in the state of MN without restrictions or pending restrictions.

  • 7 years of relevant direct clinical care or managed care experience.

  • 1 year staff, team lead or project lead experience.

  • Strong interpersonal skills to collaborate and effectively work through a complex organization to influence change.

  • Excellent organizational, change management and time management skills.

  • Well-developed written and oral communication skills with the ability to explain complex information clearly and convincingly.

  • Broad knowledge of managed care and state/federal health insurance regulations.

  • Demonstrated ability to coach, mentor and develop others.

  • Strong leadership ability, proven skills in critical thinking and ability to pursue goals with tenacity and sense of urgency.

  • Demonstrated ability to project manage resulting in desired outcomes.


Preferred Requirements


  • Previous experience in care management processes preferably in a health plan.

  • 5 years management experience or previous leadership role in Utilization Management Bachelor’s degree in health care, business administration, or education preferred. #BCBSMN


FLSA Status

Exempt

Blue Cross Blue Shield of Minnesota is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Make a difference



Thank you for your interest in Blue Cross. Be part of a company that lets you be you — and make a healthy difference in people’s lives every day



Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, or any other legally protected characteristic.



Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association


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