locations
Phoenix
time type
Full time
posted on
Posted 30+ Days Ago
job requisition id
R5146
Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
This position is responsible for oversight, development, and reporting for the Integrated Care Management Program and related care management protocols, physical and behavioral health including the SHOUT Protocol for Suicide Prevention, emergency department and inpatient readmission reduction initiatives, chronic and acute condition management, Arizona State Hospital (AzSH) and Psychiatric Security Review Board (PSRB) Care Management. The Supervisor, Integrated Care leads a team of Integrated Care Managers with nursing and behavioral healthcare backgrounds. The position is focused on supporting the integration of physical and behavioral healthcare for adult members.
Qualifications
REQUIRED QUALIFICATIONS
Required Work Experience
Minimum: 5 years of combined experience in nursing, behavioral healthcare or health plan care management
For supervision of Care Managers, 2 years experience in full-time equivalent of direct clinical care to the consumer
Required Education
Bachelor’s Degree with a Current Arizona registered nurse (RN) license; OR
Master’s degree in a Behavioral Health Field with a current independent Arizona License in Social Work, Counseling, Marriage and Family Counseling or Substance Abuse Counseling
Required Licenses
Current Arizona registered nurse (RN) license OR
Independent Arizona License in Social Work, Counseling, Marriage and Family Counseling or Substance Abuse Counseling
Required Certifications
After directly supervising the case management process for 3 years, certification in case management from the following certifications; Certified Case Manager (CCM), Certified Disability Mangement Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN, BC).
PREFERRED QUALIFICATIONS
Preferred Work Experience
Preferred: 10 years of combined experience in nursing, behavioral healthcare or health plan care management,
Prior supervisory experience
Preferred Certifications
Active and current certification in case management from the certifications listed under required certifications above.
ESSENTIAL JOB FUNTIONS AND RESPONSIBILITIES
Hire, train, mentor and support Integrated Care Managers
Administer, interpret and maintain current working knowledge of the required BCBSAZ systems, procedures, forms and manuals.
Keep status of the unit current in accordance with metrics, systems, procedures, forms and manuals through staff meetings and verbal and written communications.
Provide motivation and encouragement to subordinates, conduct performance evaluations and monthly reviews, identify and coordinate training needs, make determinations regarding disciplinary actions.
Interview, evaluate and make recommendations in regard to employment decisions.
Act as a clinical resource to staff by reviewing cases and making recommendations on member care
Assign caseloads and monitor productivity of Integrated Care Managers
Complete assigned deliverables accurately and timely
Develop and implement resources and systems to support the Integrated Care Management Program and all related care management protocols
Write and maintain policies and procedures for the Integrated Care Management Program and related care management protocols
Communicate information regarding the Integrated Care Management Program and related care management protocols to network providers and stakeholders through provider site visits, committee meetings, and email communications
Attend and participate in all team meetings and interdisciplinary care team rounds
Meet quality, quantity, and timeliness standards to achieve individual and department performance goals
Maintain all standards in consideration of state, federal, Health Choice, NCQA, and other accreditation requirements
Assist in the preparation and analysis of cost/benefit and outcomes reports.
Perform all other duties as assigned
The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements
REQUIRED COMPETENCIES
Required Job Skills
Knowledge of the AHCCCS Medicaid system
Knowledge of the principles and benefits of integrated health care
Understanding of and experience caring for individuals with Serious Mental Illness (SMI)
Knowledge of common chronic health conditions and their treatment
Familiarity with local community resources for individuals with SMI
Skilled at thinking critically and developing new processes and efficiencies
Skilled at using Microsoft Office applications, especially Excel
Ability to use basic data analysis tools to evaluate and report on program outcomes
Ability to use and manipulate large volumes of member data
Ability to work effectively in a team model
Ability to maintain confidentiality, privacy and security of protected health information and proprietary information
Some travel required
Arizona drivers’ license
Required Professional Competencies
Ability to teach and train other professionals on clinical processes
Experience managing complex and unique caseloads for persons with both physical and behavioral health needs
Ability to document activities accurately and timely in an electronic medical record system
Ability to communicate professionally in written and oral formats
Ability to deliver presentations to large groups
Ability to prioritize and effectively handle multiple projects
Corporate Responsibilities
Comply with BCBSAZ corporate and departmental policies and procedures, including, but not limited to Code Blue, Compliance, HIPAA, Computer Responsibility, Accreditation Standards, Attendance, Staff Qualifications and Quality Management Accountabilities.
Our Commitment
AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply. Click Here : Apply Now