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Manager of Care Management- Clinical Precertification

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Health & Clinical Services
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Looking for a chance to show what you can do in an environment that will appreciate you and help you grow?  If you are learning-oriented, strive for excellence, and have a strong customer commitment, bring your talents to Independence Blue Cross as we seek to enhance the health and well-being of the people and communities we serve.  As a member of Independence Health Group, we seek to innovate, reimagine and lead in the transformation of healthcare.  We are committed to attracting, retaining and growing the best talent.



Position Title:            Manager, Clinical Precert- Care Management and Coordination

 

Reports To:                Director, Care Management and Coordination

 

Wage Status: Exempt

 

 

General Summary:

 

Under the direction of the Director of Care Management and Coordination, the Manager provides direction, leadership and has overall operational responsibility for the effectiveness of the clinical precertification activities.  The manager establishes overall production and business goals, aligns strategy to financial and business targets and defines the approach to ensuring deliverables are met for the organization. Adept at building collaborative relationships that enhance the flow of information and insights necessary to drive impact for the organization; ability to influence others at all levels throughout an organization.

 

 

Major Activities:

 

1.     Strategic Thinker

2.     Change Agent

3.     Manages and enhances processes

4.     Manages resources and teams (direct and matrixed)

5.     Develops and fosters growth for direct reports

6.     Drives accountability

7.     Creates and sustains an engaging team environment.

8.     Manages the recruitment, staffing and evaluation process to ensure staff competency, development and enrichment.

9.     Evaluates the educational needs of the department and oversees the departmental orientation to ensure competency of staff, educational opportunities and achievement.

10.  Ensures that the Care Management and Coordination staff performs all key functions effectively and makes recommendations for improvement where indicated.

11.  Acts as a resource for departments, using focused professionalism and effective interactions.

12.  Ensures that all key functions are documented via Care Management and Coordination Policy.

13.  Builds team spirit and interdepartmental rapport, using effective problem solving and motivational strategy.

14.  Is comfortable with new ideas and methods; creates and acts on new opportunities; is flexible and adaptable.

15.  Committed to total quality management and process improvement.

16.  Other duties as assigned.


EDUCATION AND EXPERIENCE:

 

§  Requires the following:

a.     Current, active, and unrestricted RN

b.     BSN Preferred

 

§  (2) Two or more years experience in a supervisory/leadership role required. 

 

SKILLS:

 

Must have superior communication, team building, and problem-solving skills.  Ability to interact with all levels of management is necessary.

 

The ability to thrive in ambiguous and fast-paced environment crucial for success. Flexible and outcome focused.

 

Demonstrated success in taking risks and confronting challenging scenarios with professionalism, integrity and diplomacy.


About Our Company

Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.

 

At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations.  For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!


Equal Employment Opportunity

Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. 

Agency Disclaimer

All resumes submitted directly to an Independence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process. 

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