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Case Manager, RN
R28667 Workforce Classification: Telecommuter Join Our Team: Do Meaningful Work and Improve People’s Lives Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare. Premera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. It’s this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace. Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com/. Case Managers are a dedicated team of clinicians (RNs, behavioral health professionals, and dieticians) who utilize a holistic model that enables our members to transition towards healthier lifestyles. Who we serve: Premera Blue Cross, a nationally recognized leader in the practice of integrated case management, is looking to expand our growing team of Case Managers. Our comprehensive, whole-person health assessment helps to identify member actionable barriers and develop obtainable goals that will eventually lead to self-care. In the interim, case managers employ an integrated case management approach that recognizes making lifestyle changes is not simple and meets members where they are. We also monitor progress toward goals and facilitate the coordination of providers as needed. Our market-differentiated approach has helped thousands of members make meaningful improvements to their daily habits, health, and overall well-being. What you will get in this role:
- The opportunity to help members in a meaningful and impactful way. We know that helping people is important to you.
- The opportunity to learn and grow. You will be working with folks who literally wrote the book on integrated case management.
- The opportunity to have an impact. Your work improves the lives of our members and enables us to operate more impactfully.
- The opportunity to thrive in a career. We offer a supportive and safe environment where clinicians can work to the top of their licensure.
- The opportunity to take pride. We know your work is important just as you do.
- Engage target members (those who are facing medical, mental health and/or substance utilization disorders) and build a relationship that will support open and constructive dialog on sensitive topics.
- Conduct initial holistic health assessments that help build an understanding of a member’s specific situation and needs and identify any social determinants of health (SDOH) and cultural influences that may impact potential lifestyle changes.
- Create a space where a case manager and member can collaborate, along with relevant caregivers and providers, to develop a member-centric case management plan that sets goals, addresses potential barriers, and leads to improved health outcomes.
- Monitor, evaluate, and update the effectiveness of the member's case management plan to ensure progress toward goals is being made and that current goals remain pertinent.
- Facilitate communication and coordination among the health care team to maximize delivery of appropriate care.
- Provide interventions focused on removing barriers, promoting positive behavior change using motivational interviewing techniques, and stabilizing the members’ natural support systems by ensuring that caregiver needs are identified and being met.
- Maintain concise, accurate, and timely documentation that meets accreditation, contractual, and legal requirements.
- Active WA State or Compact License in one of the following:
- Nursing: Current registration as a nurse (e.g., RN, ARNP)
- Behavioral Health: Valid licensure (e.g., LMFT, LICSW, LMHC)
- Psychology: Board certification
- 3 years' experience with direct patient/clinical care post-licensure.
- High-speed cable, DSL, or Fiberoptic Internet, no less than 20 Mbps – Satellite and Wireless connections will not work with our equipment.)
- 1+ years prior experience as a Case Manager
- Certified Case Manager (CCM) certification
- Chemical Dependency Professional (CDP)
- Chronic Care Professional certification (CCP)
- LEAN training
- Advanced Motivational Interviewing skills
- All Case Managers are required to have a valid WA state or MSL/ Compact license and meet WA state credentialing requirements.
- Any Case Manager not holding an active Certified Case Manager (CCM) certification will have 24 months to obtain one.
- Premera provides extensive training including initial and ongoing motivational interviewing skill development.
- Support in earning your Chronic Care Professional (CCP) certificate, Integrated Case Manager (ICM) certificate, as well as your Certified Case Manager (CCM) credential.
- Since 2012, Premera has been a NCQA accredited program earning full credit for our case management program. All our clinicians receive documentation, assessment, and intervention skill training to ensure they are practicing at the highest professional skill level.
- Clinicians and managers also employ LEAN methodology that supports their active involvement in process improvement activities.
- Paid licensure renewal
- Reimbursement for CCM exam fees and renewal
- Paid membership in the National Case Management Society of America (CMSA) and the local state chapters
- This position is classified as a telecommuter.
- Training Schedule: Your training schedule for the first four to six weeks of hire will be Monday through Friday, between 8 am and 5 pm PT (Pacific Time)
- Ongoing Schedule: You will be working a 40-hour weekly schedule that includes 5 hours that will provide coverage for extended hours (Monday through Friday between 5 and 7 pm or Saturday between 9 am and 2 pm. Note: all times are Pacific)
- Please note: Schedules are subject to periodic change due to member coverage requirements.
- Medical, vision, and dental coverage with low employee premiums.
- Voluntary benefit offerings, including pet insurance for paw parents.
- Life and disability insurance.
- Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.
- Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.
- Generous paid time off to reenergize.
- Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.
- Employee recognition program to celebrate anniversaries, team accomplishments, and more.
- Commuter perks make your trip to work less impactful on the environment and your wallet.
- Free convenient on-site parking.
- Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable.
- Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.
- Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.
- Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus.