Manager, Case Management

Manager, Case Management Team

Join Our Team : Do Meaningful Work and Improve People's Lives

Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.

To better serve our customers, we are fostering a culture that emphasizes employee growth, collaborative innovation, and inspired leadership. We are dedicated to creating an environment where employees can excel and where top talent is attracted, retained, and thrives. As a testament to these efforts, Premera has been recognized on the 2025 America's Dream Employers list. Newsweek honored Premera as one of America's Greatest Workplaces, America's Greatest Workplaces for Inclusion, and America's Greatest Workplaces For Mental Well-Being, and Forbes ranked Premera among America's Best Midsize Employers for the fourth time.

This is a work from home opportunity! Please note this position aligns to PST business hours.

The Manager, Case Management Team is a Supervisor for Case Managers. This position is responsible for the execution and implementation of Clinical Programs' strategy and goals and the oversight of Clinical Programs' operations. The incumbent oversees the effective integration and continuous improvement of processes and systems to meet Premera's current and future business goals. Responsibilities also include managing and developing a team of clinical and support staff promoting their professional growth and operational effectiveness.

What You'll Do :

• Participate in development of Clinical Programs' strategy and planning in accordance with company's mission and strategic goals, federal and state law and regulations, and accreditation standards.
• Assist in the selection, training, evaluation, and development of professional, paraprofessional, and administrative team members.
• Lead Care Management teams in effective performance of job functions, which may include preauthorization, outpatient and inpatient management, case management, retrospective claim review, and delegated management oversight.
• Participate in the development and monitoring of budgets in accordance with department and organizational objectives.
• Assist with the adjustment and direction of work processes to support cost and utilization variations.
• Participate in the development, implementation, and monitoring of the department's performance standards, utilizing quality improvement methodologies to refine procedures.
• Participate in the establishment and implementation of Care Management policies as required.
• Foster collaborative work environment that encourages team building, facilitates cohesive synergetic performance of Care Management functions, while valuing the individual diversity and uniqueness of all employees.
• Build and maintain cooperative business relationships.
• Participate in Total Quality Management activities and processes to assure operational compliance with regulatory requirements, including NCQA, NEMIS, HCFA, and OIC.
• Ensure team members that can articulate the expectations of performances are invested in productivity and customer service, and can describe a positive feeling about the work environment.
• Effectively manages deficits with improvement plans and consistent follow-up.
• As part of this role, you may be assigned internal controls derived from Premera's internal controls framework. You will be accountable for understanding the controls assigned to you, their impacts on Premera, and to ensure that they are operating effectively.

What You'll Bring :

Premera Total Rewards

Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including :

For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.

Equal Employment Opportunity

Premera is an equal opportunity / affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785.

Premera is hiring in the following states, with some limitations based on role or city : Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

The pay for this role will vary based on a range of factors including, but not limited to, a candidate's geographic location, market conditions, and specific skills and experience.

The salary range for this role is posted below; we generally target up to and around the midpoint of the range.

National Salary Range : $87,000.00 - $147,900.00

National Plus Salary Range : $99,100.00 - $168,500.00