Summary
 

Why should you join the BlueCross BlueShield of South Carolina family of companies?

Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Position Purpose:

The Care Connected Clinical Program Manager is responsible for the development and management of a key concierge care program. In this role, you will assess impact of programs which may include: performing cost-benefit/feasibility analyses, performing market research assessing corporate competitiveness. You will provide strategic direction for reporting, including design, analysis, and validation of outcomes and ROI in a fast-paced, growing environment with shifting priorities.

Description
 

Logistics:

This position is full-time (40 hours/week, 8 hours/day) Monday – Friday, REMOTE – W@H South Carolina, W@H Georgia, or W@H North Carolina. Periodic travel to Columbia, SC for meetings.

What You'll Do:

• Develop, implement, evaluate, and maintain health management programs.

• Position BlueCross BlueShield of South Carolina to compete effectively with other companies.

• Achieve positive return on investment through oversight of new product/technology development and promotion of service enhancement strategies to increase customer retention.

• Develop and conduct health management presentations to management, internal and external customers that are informative and customized to meet health plan and customer needs.

• Establish reporting mechanism that details clinical outcomes, utilization statistics and ROI.

• Develop and maintain specific reporting to include tracking of efficacy, clinical/financial outcomes, research analysis, and the accuracy/timeliness of data collection.

• Provide leadership and direction to staff through employee development, management training, and budget oversight.

• Develop, implement, comply with and promote staff adherence to corporate and department policies, procedures, and performance and communication standards.

• Comply with and monitor adherence to URAC case management standards, SC Department of Insurance regulations, SC Nurse Practice Act, all applicable state and federal laws and standards of national accreditation agencies, as management deems necessary.

To Qualify for This Position, You'll Need:

• Required Education: Bachelor's degree

• Degree Equivalency: Graduate of Accredited School of Nursing. (Equivalency not applicable for the Celerian Group. Bachelor's degree required.)

• Required Work Experience: 5 years clinical or experience developing, implementing and evaluating population health programs with two of the five years in a supervisory role or equivalent military experience in grade E4 or above.

• Required Skills and Abilities:

  • Ability to understand and communicate healthcare policy

  • Working knowledge of word processing, spreadsheet, and presentation software

  • Ability to work independently, prioritize effectively, and