Join Blue Shield of California as a Senior Manager in Care Management, where you'll lead Medi-Cal initiatives, mentor nurses, and drive innovative care delivery. This role emphasizes leadership, collaboration, and a commitment to enhancing the health and quality of life for members, making a significant impact in population health management.
Key Responsibilities
Establish operational objectives for department.
Responsible for team and department results in planning and methods.
Participate in the development of the annual budget.
Ensure documentation of workflow procedures and guidelines.
Interpret or initiate changes in guidelines/policies/procedures.
Provide leadership for resource utilization and compliance.
Enhance care management processes in compliance with regulations.
Maintain operational readiness for audits.
Engage with committees and service providers for care delivery.
Focus on improving quality of life and health for members.
Lead positive change in care management programs.
Develop client health education and support initiatives.
Promote best practices impacting social determinants of health.
Represent Blue Shield in community events.
Collaborate with other managers in care management.
Maintain daily measurement standards for staff.
Participate in practice transformation.
Required Qualifications
Bachelor's degree or equivalent experience
Current CA RN License
Certified Case Manager (CCM) Certification or in process of completion
At least 10 years of prior relevant experience
4 years of management experience
Health insurance/managed care experience
Excellent communication, presentation, and procedure-writing skills