Manager, Behavioral Health Case Management

Care Management, Clinical Experience, Clinical Quality Management, Clinical Review, Code of Federal Regulations, Health Insurance Operations, Managed Care, Patient Safety, People Management, Policy Compliance, Policy Implementation, Population Health Management, Quality Improvement, Quality Management, Regulatory Compliance, Standards Compliance

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Experience in population health, care management, clinical review or coding, or utilization management in a health care organization/system or health insurance

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets,  licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$107,901.00 - $172,642.00

We’re hiring a Manager, Behavioral Health Case Management, to collaborate and engage with multiple internal stakeholders and external customers (i.e.

providers, vendors, employer groups) to implement population health management and promote a collaborative, integrated culture across lines of business/segments.

You will support value-based strategy by leading multiple clinical or non-clinical teams/staff focused on improving member health through proactive and professional services in the following areas: clinical determinations, case management, disease management, wellness, medical policy, medical review, and/or related services.

Assist in the development of operational strategies and innovative solutions for area(s) of clinical oversight; facilitate favorable medical expense, administrative pricing and/or efficiencies.

Maintain awareness of trends, developments, and governmental regulations in managed health care organizations and product line(s) under leadership purview and recommend associated policy positions, new initiatives and/or existing program changes to improve the company’s competitive position.

Use competitive intelligence to guide, consult and drive strategic program and product development and management