Your Role

The Care management team is looking for a leader with Medi-Cal experience who can help design and lead our Medi-Cal line of business. The Senior Manager of Care Management, Medi-Cal will report to the Sr. Director of Population Health Management. In this role you will be will serve as the professional leader of registered nurses within Blue Shield care management who is a good collaborator, experienced in people leadership, and will serve as a mentor and advisor to senior leadership. The selected candidate will also function as the subject matter expert on professional nursing/ care management for Medi-Cal regulations- who will represent care management in initiatives, client presentations, act as a liaison between other business units within Blue Shield to bolster care management knowledge on community resources, best practices, and promote holistic and integrated approach to medical care management. . Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Current CA RN license.
• Bachelors of Science in Nursing or advanced degree preferred.
• Certified Case Manager (CCM) or is in the process of completing certification when eligible based on CCM application requirements.
• Requires at least ten (10) years of prior experience in healthcare related field including 4 years of management experience.
• Three (3) years conducting Care Management for a health insurance plan or managed care environment preferred
• Proficient with Microsoft Excel, Outlook, Word, Power Point, and the ability to learn and utilize multiple systems/databases
• 3+ years of experience in an administrative management position in a health care setting preferred
• 3+ years of responsibility for the supervision of professional staff, budgeting, program planning and licensing preferred
• Familiarity with NCQA requirements
• Successful track record in building and maintaining positive cross-functional relationships
• Aptitude for developing a quick understanding of people, processes, and technology
• Excellent analytical, communication skills, written skills, time management, and organizational skills
• Possess outstanding interpersonal, organizational, and communication skills, positive attitude, and high level of initiative

Pay Range:

The pay range for this role is: $ 136400.00 to $ 204600.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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