Case Manager

Responsibilities

• 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.

Requirements

• Required:
• 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.
• Internet access through any Internet Service Provider (ISP) with a minimum connection speed of 75 Mbps (megabits per second) download speed
• Preferred:
• 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
• Licensing and Certification Expectations:
• 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.
• Training and Perks:
• Premera provides

Benefits

Additional Information

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

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