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Job Description
Join Blue Shield of California as a Senior Manager in Case Management, where you'll lead Medi-Cal initiatives and mentor a team of registered nurses. This role emphasizes collaboration, regulatory compliance, and innovative healthcare delivery to improve the quality of care for members.
Key Responsibilities
Establish operational objectives for the department
Plan and manage team results in collaboration with the Director
Develop and implement the annual budget
Document and communicate workflow procedures and guidelines
Provide leadership for resource utilization and regulatory compliance
Enhance care management processes in compliance with regulations
Maintain operational readiness for audits
Collaborate on community care delivery projects
Promote quality of life and health for members
Advocate for innovative care management programs
Develop client health education and support
Represent care management at community events
Required Qualifications
Bachelor's degree or equivalent experience
Current CA RN License
Certified Case Manager (CCM) Certification or in process
At least 10 years of relevant experience
4 years of management experience
Health insurance/managed care experience
Excellent communication, presentation, and procedure-writing skills