Case Manager

Premera Blue Cross Premera Blue Cross · Insurance · Telecommuter

This role is for a Case Manager at Premera Blue Cross, focusing on supporting members with behavioral health needs through a whole-person care model. Responsibilities include conducting holistic health assessments, developing and monitoring member-centric case management plans, facilitating communication among healthcare teams, and providing interventions for behavior change. Requires active nursing or behavioral health licensure and direct patient care experience. Preferred qualifications include prior case management experience and specific certifications.

What you'd actually do

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. Facilitate communication and coordination among the health care team to maximize delivery of appropriate care.

Skills

Required

  • Active WA State or Compact License in Nursing (RN, ARNP) or Behavioral Health (LMFT, LICSW, LMHC) or Psychology (Board certification)
  • 3 years' experience with direct patient/clinical care post-licensure
  • Internet access with minimum 75 Mbps download speed

Nice to have

  • 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

What the JD emphasized

  • Active WA State or Compact License
  • 3 years' experience with direct patient/clinical care post-licensure
  • Internet access through any Internet Service Provider (ISP) with a minimum connection speed of 75 Mbps (megabits per second) download speed