Care Management Supervisor (Remote in SC)

Remote Health Management Supervisor

Responsible for the supervision and maintenance of the daily functions of the following areas : Utilization Review / Review Nurses, Case Management, Medical Review, Health / Disease Management, Quality Management, and / or Appeals, to include departmental staff and specialty programs. Responsible for all data collection for specialty programs and ensures appropriate levels of healthcare services are provided.

Location : This position is full-time (40-hours / week) Monday-Friday from 8 : 00am-4 : 30pm or 8 : 30am 5 : 00pm and will be fully remote. The candidate may be asked to come on-site for training, meetings, or other business needs.

What You'll Do :

• Supervises day-to-day activities for assigned staff. Identifies training needs of staff. Verifies accuracy, efficiency, and effectiveness of workflow functions. Develops and oversees the implementation and administration of specialty programs (wellness, preventive, and / or employer work site programs).
• Supervises staff to include approval of time, leave, performance reviews, etc. Selects / trains / motivates staff in providing excellent customer service with customers, marketing, management / others.
• Develops / maintains / updates procedures / documentation for conducting audits. Develops / communicates department standards and expectations of staff. Performs quality control functions for work performed. Develops work plans to improve quality performance.
• Conducts analysis of program component. Collects data for outcomes reporting. Prepares / reviews / maintains weekly / monthly reports for management. Oversees all data collection and URAC / NCQA compliance activities for related programs.
• Coordinates with other corporate departments to ensure effective communication.

To Qualify for This Position, You'll Need the Following :

What We Prefer You to Have :

Our Comprehensive Benefits Package Includes the Following :

What We Can Do for You :

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email mycareer.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

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