Hybrid Manager, Behavioral Health Care Management na Blue Shield of California Group
Blue Shield of California Group · Long Beach, Estados Unidos Da América · Hybrid
- Senior
- Escritório em Long Beach
Your Role
The Manager Care Management–Behavioral Health will report to the Senior Manager Care Management – Behavioral Health. The role of Manager, Care Management – Behavioral health will be critical to the success of Blue Shield of California and the Commercial BH Care Management department in realizing it’s goals and objectives. This position will support all aspects of care management and care coordination of behavioral health membership for commercial lines of business. In this role you will be responsible for managing care management programs, optimizing patient outcomes, improving care delivery processes, and ensuring compliance with regulatory requirements. The Manager will supervise a team of Behavioral Health Case Managers while collaborating with healthcare providers, payers, and members to achieve optimal clinical outcomes. 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.
Responsibilities
Your Work
In this role, you will:
Manage all aspects of day-to-day operations of the Behavioral Health CM program, including adherence to regulatory compliance and direct oversight of performance quality.
- Be responsible for team, department or functional area results in terms of planning, cost in collaboration with Sr Manager
- Ensure workflow procedures and guidelines are clearly documented and communicated
- Interpret or initiate changes in guidelines/policies/procedures
- Support the development of goals for the department and planning efforts (budgets, operational plans, etc.).
- Provide training and information about care management requirements to the staff.
Build and maintain key working relationships across BSC related to your assigned functional area; consult with operations on ad hoc inquiries and requests for guidance
Support team through consistent and successful caseload management and workload to achieve team goals, regulatory timelines, and accreditation standards
Qualifications
Your Knowledge and Experience
Requires Clinically Licensed Behavioral Health Practitioner or Registered Nurse or with a current unrestricted CA license (LCSW, LMFT, LPCC, Licensed Psychologist, or Registered Nurse (RN) with Behavioral Health experience)
Advanced degree commensurate with experience required
Certified Case Manager (CCM) Certification or is in process of completing certification when eligible based on CCM application requirements
Requires at least 7 years of prior relevant experience including 3 years of management experience gained as a team leader, supervisor, or project/program manager.
Three (3) years conducting Care Management for a health insurance plan or managed care environment preferred
Comprehensive knowledge of case management, discharge planning, utilization management and community resources. Strong supervisory, communication and negotiation skills.
Proficient with Microsoft Excel, Outlook, Word, Power Point, and the ability to learn and utilize multiple systems/databases
Basic familiarity with accreditation bodies
Possess outstanding interpersonal, organizational, and communication skills, positive attitude, and high level of initiative
Ability to identify problems and works towards problem resolution independently, seeking guidance as needed
About Company
About Blue Shield of California
As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!
Our Values:
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
- Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model:
At Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose – whether working in the office or through a hybrid approach – by providing clear expectations while respecting the diverse needs of our workforce.
Two Ways of Working:
- Hybrid (Default): Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above). Exceptions:
o Member-facing and approved out-of-state roles remain remote.
o Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits.
o For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
- On-Site: Work from a business unit-approved office an average of four (4) or more days a week.
Physical Requirements:
Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.
Please click here for further physical requirement detail.
Equal Employment Opportunity:
External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
