Sr Team Lead HCS Clinical position at Premera Blue Cross in Mountlake Terrace

Premera Blue Cross is currently seeking to employ Sr Team Lead HCS Clinical on Thu, 04 Jul 2013 13:30:13 GMT. Job Summary: Provide leadership to Care Management teams to assure implementation of the Care Management programs and is responsible for assessing, developing, and implementing Care Management strategies, as well as, participating in the hiring, developing, and supporting of staff members. Responsibilities: 1. Assist in the Development and operationalization of Care Management programs to meet...

Sr Team Lead HCS Clinical

Location: Mountlake Terrace Washington

Description: Premera Blue Cross is currently seeking to employ Sr Team Lead HCS Clinical right now, this position will be placed in Washington. For detail informations about this position opportunity kindly see the descriptions. Job Summary:
Provide leadership to Care Management teams to assure implementation of the Care Management programs and is responsible for assessing, developin! g, and implementing Care Management strategies, as well as, participating in the hiring, developing, and supporting of staff members.

Responsibilities:
1. Assist in the Development and operationalization of Care Management programs to meet the strategic initiatives of Premera and Health Care Services
2. Assist in the selection, training, evaluation, and development of professional paraprofessional, and administrative team members.
3. Lead Care Management teams in effective performance of job functions, which may include preauthorization, outpatient and inpatient management, case management, retrospective claim review, and delegated management oversight.
4. Participate in the development and monitoring of budgets in accordance with department and organizational objectives.
5. Assist with the adjustment and direction of work processes to support cost and utilization variations.
6. Participate in the development, implementation, and moni! toring of the department’s performance standards, utilizing ! quality improvement methodologies to refine procedures.
7. Participate in the establishment and implementation of Care Management policies as required.
8. Foster collaborative work environment that encourages team building, facilitates cohesive synergetic performance of Care Management functions, while valuing the individual diversity and uniqueness of all employees.
9. Build and maintain cooperative business relationships.
10. Participate in Total Quality Management activities and processes to assure operational compliance with regulatory requirements, including NCQA, NEMIS, HCFA, and OIC.
11. Ensure team members that can articulate the expectations of performances are invested in productivity and customer service, and can describe a positive feeling about the work environment.
12. Effectively manages deficits with improvement plans and consistent follow-up.

Minimum Qualifications:
1. Case Management Team Leads who supervise Case! Managers will obtain CCM accreditation from the URAC-approved list of certifications within three (3) years from date of hire.
2. Case Management Team Leads must meet one of the following qualifications: A bachelor's degree in health related field and licensure as a health professional; certification as a case manager; professional certification in a clinical specialty and at least 5 years experience as a case manager.
3. Bachelor’s Degree in nursing, management-related, or equivalent work experience.
4. Demonstrated management experience as supervisor, team lead and/or other positions requiring effective use of leadership skills;
5. Three to five years care management experience in payer, provider, or government setting.
6. Ability to work under pressure with limited resources, completing priorities and specific project timeliness.
7. Expertise in health care cost management with demonstrated ability to design, implement, and evaluate new program! s.
8. Demonstrated negotiation and collaborative problem-solving sk! ills.
9. Ability to train staff in the clinical and administrative tools necessary to manage healthcare costs.
10. Knowledge of the health care community.
11. Excellent verbal and written communication skills.
12. Analytical skills and PC application experience.
13. Proven positive interpersonal and human relations skills.
14. Claims and/or customer service experience preferred.

Working Conditions:
Work is performed within a normal office environment with ambient temperatures and involving occasional reaching, stretching, bending and moving about.
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to Premera Blue Cross.

If you interested on this position just click on the Apply button, you will be redirected to the official website

This position starts available on: Thu, 04 Jul 2013 13:30:13 GMT

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