National Salary Range:
$68,400.00 - $116,300.00
National Plus Salary Range:
$77,300.00 - $131,400.00
*National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.
4 Year Degree
20 openings available.
Telecommuting is allowed.
Internal Number: R26054
This is a work from home opportunity!
Who we are Case Managers work within a team of interdisciplinary trained and licensed clinicians including registered nurses, licensed behavioral health clinicians, dieticians and support staff providing case management, care transition management and other specialized services. We are a member facing team and are under the division of Integrated Health Management.
Who we serve We provide a holistic model which involves collaboration with members and their families, caregivers, employer groups and providers. Case Managers use an integrated (physical/mental health) case management program and a collaborative, relationship-based approach, to assist poly-chronic and high-risk members to improve health outcomes. We utilize a comprehensive, whole person health assessment of member's current situation and status, identify actionable barriers and obtainable goals to achieve optimal self-care management, and monitor members’ progress toward goals. We facilitate coordination, communication, and collaboration among the members’ providers to advocate for members, while promoting member long term self-management and advocacy. We actively assist members to obtain appropriate quality care within their benefit plan and identify resources in the community or within the member's natural support system to fill any gaps within their benefit plan.
Our teams use Motivational Interviewing (MI) techniques, a method which involves asking thoughtful, purposeful questions. Motivational Interviewing works by activating the members’ own motivation for change, which can empower, and fuel personal motivation and confidence needed to pursue change.
What you will do:
Engage members with medical, mental health and/or substance utilization disorders in health support services utilizing evidenced-based engagement skills.
Conduct initial holistic health assessment of member's current conditions, situation and needs and perform ongoing evaluations. Assessment will include evaluating the members’ social determinants of health (SDOH) and cultural influences on health care practices.
Collaborate with the member, caregivers, and providers to develop a member centric case management plan that addresses barriers and promotes improved health outcomes.
Monitor and evaluate the effectiveness of the member's case management plan and continuously update to ensure goals are progressing and remain pertinent; identify and address barriers to completing goals.
Facilitate communication and coordination among the health care team to minimize fragmentation, eliminate duplication, and maximize delivery of appropriate care.
Provide interventions focused on removing the members’ barriers to health improvement, promoting positive behavior change using motivational interviewing techniques, and addressing the caregiver's needs in order to stabilize the members’ natural support systems.
Maintain concise, accurate and timely documentation that supports effective, efficient management of the member and that meets accreditation, contractual and legal requirements.
What you will bring:
Registered Nurse or Master's/Doctoral degree in health or human services related field (e.g., Social Work, Marriage and Family Therapy, etc.) (Required)
Current state credential (e.g., licensure) that allows the professional to conduct an assessment independently as permitted within the discipline's scope of practice: (Required)
For nurses, required registration and licensure (e.g., RN ARNP)
Prior experience as a Case Manager highly preferred.
Integrated Case Management certificate (ICM), Chemical Dependency Professional (CDP).
High Speed Cable, DSL or Fiberoptic Internet, no less than 20 mbps – Satellite and Wireless connections will not work with our equipment. (Required)
Premera provides extensive training including initial and ongoing motivational interviewing skill development and assists personal health support clinicians and managers in earning their Chronic Care Professional (CCP) certificate, Integrated Case Manager (ICM) certificate, as well as their Certified Case Manager (CCM) credential. Premera is NCQA accredited program earning full credit for our case management program for the past two audits. As such, all our clinicians receive documentation, assessment, and intervention skill training to ensure they are practicing at the highest professional skill level. Clinicians and managers also employ LEAN methodology that supports their active involvement in process improvement activities.
This team requires 5 hours each week between 5pm – 7pm PST Monday - Friday or Saturday 9am – 2pm PST (Pacific Standard Time) to provide extended coverage to members.
Premera was recognized as one of America's Best Midsize Employers by Forbes in 2022 and 2023!
We put our members first.
In the world of healthcare, people make the difference. We’ve been working hard to improve healthcare, keeping our members and their loved ones at the center of all we do.
We’ve provided access to healthcare for people in Washington state since 1933, and in Alaska since 1952. Our goal has always been to provide quality and cost-effective healthcare plans for our members. We’ve have done that for almost 90 years, and our effort is continuous.
What Information Do We Collect?
When you visit our website you may provide us with two types of information: personal information you knowingly choose to disclose that is collected on an individual basis and website use information collected on an aggregate basis as you and others browse our website.
Personal Information You Choose to Provide
We may request that you voluntarily supply us with personal information, including your email address, postal address, home or work telephone number and other personal information for such purposes as correspondence, placing an order, requesting an estimate, or participating in online surveys.
If you choose to correspond with us through email, we may retain the content of your email messages together with your email address and our responses. We provide the same protections for these electronic communications that we employ in the maintenance of information received by mail and telephone.
Website Use Information
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Broadly speaking, we use personal information for purposes of administering our business activities, providing service and support and making available other products and services to our customers and prospective customers. Occasionally, we may also use the information we collect to notify you about important changes to our website, new services and special offers we think you will find valuable. The lists used to send you product and service offers are developed and managed under our traditional standards designed to safeguard the security and privacy of all personal information provided by our users. You may at any time to notify us of your desire not to receive these offers.
What Are Cookies?
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How Do We Use Information Collected From Cookies?
We use website browser software tools such as cookies and web server logs to gather information about our website users' browsing activities, in order to constantly improve our website and better serve our users. This information assists us to design and arrange our web pages in the most user-friendly manner and to continually improve our website to better meet the needs of our users and prospective users.
Cookies help us collect important business and technical statistics. The information in the cookies lets us trace the paths followed by users to our website as they move from one page to another. Web server logs allow us to count how many people visit our website and evaluate our website's visitor capacity. We do not use these technologies to capture your individual email address or any personally identifying information about you.
Notice of New Services and Changes
Occasionally, we may use the information we collect to notify you about important changes to our website, new services and special offers we think you will find valuable. As a user of our website, you will be given the opportunity to notify us of your desire not to receive these offers by clicking on a response box when you receive such an offer or by sending us an email request.
How Do We Secure Information Transmissions?
When you send confidential personal information to us on our website, a secure server software which we have licensed encrypts all information you input before it is sent to us. The information is scrambled en route and decoded once it reaches our website.
Other email that you may send to us may not be secure unless we advise you that security measures will be in place prior to your transmitting the information. For that reason, we ask that you do not send confidential information such as Social Security, credit card, or account numbers to us through an unsecured email.
How Do We Protect Your Information?
Information Security -- We utilize encryption/security software to safeguard the confidentiality of personal information we collect from unauthorized access or disclosure and accidental loss, alteration or destruction.
Evaluation of Information Protection Practices -- Periodically, our operations and business practices are reviewed for compliance with organization policies and procedures governing the security, confidentiality and quality of our information.
Employee Access, Training and Expectations -- Our organization values, ethical standards, policies and practices are committed to the protection of user information. In general, our business practices limit employee access to confidential information, and limit the use and disclosure of such information to authorized persons, processes and transactions.
How Can You Access and Correct Your Information?
You may request access to all your personally identifiable information that we collect online and maintain in our database by emailing us using the contact form provided to you within the site structure of our website.
Do We Disclose Information to Outside Parties?
What About Legally Compelled Disclosure of Information?
We may disclose information when legally compelled to do so, in other words, when we, in good faith, believe that the law requires it or for the protection of our legal rights.
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