Care Manager

13 hours ago


Lakewood, California, United States Blue Shield of California Full time
About the Role

We are seeking a highly skilled and experienced Care Manager to join our team at Blue Shield of California. As a Care Manager, you will play a critical role in ensuring that our members receive high-quality, cost-effective healthcare services.

Key Responsibilities
  • Develop and implement individualized care plans to promote quality of care and cost-effective healthcare services.
  • Coordinate with specialists, community resources, and healthcare providers to ensure seamless transitions of care.
  • Assess and evaluate member health behaviors, cultural influences, and client belief/value systems to identify potential barriers to care.
  • Research opportunities for improvement in assessment methodology and actively promote continuous improvement.
  • Develop and implement contingency plans to adapt to changes in member health and care needs.
Requirements
  • Current CA RN License
  • Certified Case Manager (CCM) Certification or in process of completing certification
  • At least 5 years of prior experience in nursing, healthcare, or related field
  • Minimum of 3+ years managed care experience in inpatient, outpatient, or managed care environment
  • Health insurance/managed care experience preferred
  • Transitions of care experience preferred
What We Offer

We offer a competitive salary range of $ to $ for this role in California.

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade.


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