[Hiring] Case Manager @Premera Blue Cross

Role Description

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.

Our Case Managers are a compassionate team of clinicians who support members through a whole‑person care model. We partner with individuals to understand their unique medical health needs, remove barriers, and empower meaningful progress toward emotional well‑being and healthier daily living.

What you will get in this role:

• The opportunity to help members in a meaningful and impactful way.
• The opportunity to learn and grow.
• The opportunity to have an impact.
• The opportunity to thrive in a career.
• The opportunity to take pride.

What you will do:

• Engage members who are facing medical 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.

Qualifications

• Active WA State or Compact RN or ARNP license that allows you to conduct an assessment independently.
• 3 years' post licensure direct care experience.
• 1 year of post-licensure case management experience involving care coordination, care planning, discharge planning, or management of patient care over time.

Preferred Qualifications

• Certified Case Manager (CCM) certification (required to obtain within 24 months of hire if not already certified).
• Bachelor’s or Master’s degree.
• 4 or more years direct care experience across multiple patient populations, conditions, or care settings.
• Motivational interviewing experience.
• Chronic Condition Certifications (Asthma, Cardiology, Diabetes, High Risk Maternity, Oncology, Pediatrics).
• Integrated Case Management certificate (ICM).
• Chemical Dependency Professional (CDP) certification.
• LEAN training.

Conditional Requirements

• Individuals residing outside Washington must have or obtain the appropriate Washington State license (apply within 10 days of acceptance).
• Internet access through any Internet Service Provider (ISP) with a minimum connection speed of 75 Mbps (megabits per second) download speed.

Training and Perks

• Paid licensure renewal.
• Reimbursement for CCM exam fees and renewal.
• 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.
• NCQA accredited program since 2012.
• Paid membership in the National Case Management Society of America (CMSA) and the local state chapters.

Work Location and Schedule

• This position is classified as a telecommuter.
• Training Schedule: Your training schedule for the first 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).

Benefits

• Medical, vision, and dental coverage with low employee premiums.
• Voluntary benefit offerings, including pet insurance.
• Life and disability insurance.
• Retirement programs, including a 401K employer match and a pension plan vested after 3 years of service.
• Wellness incentives with a wide range of mental well-being resources.
• Generous paid time off.
• Tuition assistance for both undergraduate and graduate degrees.
• Employee recognition program.
• Commuter perks and free on-site parking.
• Subsidized on-campus cafes.
• Access to fitness & well-being center.

Equal Employment Opportunity/Affirmative Action

Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.