Manager, Case Management Nurse Management

Blue Cross And Blue Shield Association Rancho Cordova , CA 95741

Posted 4 weeks ago

Your Role

The Care Management team is looking for a leader with Care Management experience who can help design and lead our Population Health management (PHM) Medi-Cal Care Management line of business. The Manager, Care Management will report to the Senior Manager of Care Management - PHM. In this role you will act as the practice and operational leader for the care managers. You will have oversight of Care Management case compliance, reporting, and outcomes. 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 Work

In this role, you will:

  • Establish operational objectives for department or functional area and participate with other managers to establish group objectives

  • Be responsible for team, department, or functional area results in terms of planning, cost in collaboration with Sr Manager

  • Participate in the development and implementation of the annual budget under the direction of the Director

  • Ensure workflow procedures and guidelines are clearly documented and communicated

  • Interpret or initiate changes in guidelines/policies/procedures

  • Responsible for the overall effectiveness of the assigned business unit.

  • This position oversees the day-to-day operations of business units and execution of departmental goals and objectives, to promote the delivery of quality, cost-effective healthcare services based on medical necessity and contractual benefits across the continuum of care.

  • Works collaboratively among business units to align and partner with others to achieve performance goals and/or outcomes

  • Interprets and applies policies and procedures and makes decisions on a variety of matters consistent with goals and objectives of group.

  • Provides guidance and leadership for team members; monitors on-going performance; communicates expectations and results on a regular basis; communicates and interprets changes in guidelines, policies, procedures and other related matters.

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Manager, Case Management Nurse Management

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