Director-Care Management

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="https://www.bcbsm.com/" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="http://www.bcbsm.com/index/about-us/our-company.html" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="https://bcbsm.taleo.net/careersection/2/jobsearch.ftl?lang=en" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions. http://www.bcbsm.com

keywords: operations,management,teamwork,leadership,process management,performance,compliance,training,department preferences,education and experience,skills

Full-time

Competitive Total Compensation Package

Overview: <p style="font-weight: 400;"><strong><u>Departmental Summary/Preferences:<br /><br /></u></strong>This position reports to the Vice President of Care Management in the division of Health Care Value. The Director of Care Management leads a multi-disciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and social needs.<br /><br />The Director works collaboratively as part of the CM leadership team to deliver all aspects of the CM program including development, implementation, performance management, evaluation, product strategy and customer support. They also act as a liaison to other internal departments such as medical affairs, utilization management, audit, customer service and group sales.<br /><br />This position is responsible for the day to day operations and human resource management of a multi-disciplinary team including RN Care Managers, Social Workers, Pharmacists, Dietitians, Behaviorists, and non-clinical support staff.</p>
Responsibilities: <ul> <li>Lead and direct activities of multiple regional teams, including but not limited to planning, staff development, problem solving and communications.</li> <li>Establish business goals and objectives incorporating operational metrics and program evaluations for multiple units.</li> <li>Manage professional exempt, non-bargaining unit employees.</li> <li>Lead and support continuous quality improvement.</li> <li>Manage and develop business unit leadership.</li> <li>Provide effective/efficient solutions to complex business problems.</li> <li>Provide high level oversight and leadership to multiple business units and lead change effectively.</li> <li>Ensure that accreditation and/or regulatory compliance are met.</li> <li>Deliver an effective employee training program incorporating the elements of design, development and evaluation.</li> <li>Interface with HR departments, including but not limited to; HR Business Partner, Recruitment, Compensation, Employee Relations and Employee Services.</li> <li>Collaborate and support the design and development of program clinical pathways.</li> <li>Collaborate and support program evaluation design including specifying indicators of program success, defining the scope of the evaluation.</li> <li>Lead day-to-day management of multiple programs initiatives by establishing project plans and objectives to ensure team goals are met.</li> </ul> <p><strong>Corporate Requirements:</strong></p> <ul> <li>Responsible for planning, organizing, directing, controlling and leading multiple business units. Set vision and identify strategic direction for the business units. Support corporate goals and objectives.</li> <li>Direct activities of multiple functional areas, including but not limited to planning, staff development, problem solving and communications.</li> <li>Establish for the business units, goals and objectives that support continuous quality improvement.</li> <li>Manage and develop business unit leadership.</li> <li>Provide effective/efficient solutions to complex business problems.</li> <li>Provide high level oversight and leadership to business unit and lead change effectively.</li> </ul>
Requirements: <span style="text-decoration: underline;"><strong>Department Preferences</strong></span><strong><strong>:<br /></strong></strong> <ul> <li>7 to 10 years&rsquo; experience working in a health insurance plan, health provider organization or public health or community-based agency in a similar capacity.</li> <li>Five (5) or more years&rsquo; experience in developing and evaluating clinical programs.</li> <li>Five (5) to ten (10) years&rsquo; experience in a leadership role.</li> <li>Proven ability to lead a large clinical team to deliver care management programs efficiently and effectively.</li> <li>Demonstrated ability to present CM program description and results to external employer group customers.</li> <li>Proven ability to successfully navigate complex projects and initiatives in a large corporate organization.</li> <li>Intermediate to advanced computer skills and experience with Microsoft Word, Excel and Outlook.</li> <li>Bachelor's Degree in Nursing with a current MI Nursing license.</li> <li>Certification in Case Management (CCM) or eligible to obtained within 12 months of hire.</li> </ul> <p><strong>Qualifications</strong></p> <ul> <li>Bachelor's Degree in related field required. Master's Degree in related field considered a plus.&nbsp;</li> <li>Five (5) to ten (10) years&rsquo; experience in related field including experience in a managerial role.</li> <li>Ability to work effectively in a team environment.</li> <li>Strong organizational, planning, analytical and communication skills.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> </ul>