Awarded the Best Place to Work 2021, Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering 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, 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.
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
- 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
- Current Arizona registered nurse (RN) license OR
- Independent Arizona License in Social Work, Counseling, Marriage and Family Counseling or Substance Abuse Counseling
- After directly supervising the case mangement 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 Work Experience
- Preferred: 10 years of combined experience in nursing, behavioral healthcare or health plan care management,
- Prior supervisory experience
- Active and current certification in case management from the certifications listed under required certifications above.
- 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 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
BCBSAZ 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.