Senior Manager Clinical Programs (Case Management)

Workforce Classification:

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, Forbes ranked Premera among America’s Best Midsize Employers for the fourth time.

Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog:  https://healthsource.premera.com/.

As a Senior Manager, Clinical Programs (Case Management), you will be responsible for operations and the execution and implementation of strategy and goals related to Clinical Programs. In addition, you will be accountable for ensuring effective integration and continuous improvement of processes and systems to meet Premera's current and future business needs and goals. Functional and budgetary areas of accountability include one or more of the following: personal health support services including dedicated teams, engagement team, and/or support services.

This is a virtual/telecommuter position, working from home.

What you’ll do:

• Participate in the development of Clinical Program’s strategy and plan in accordance with company's mission and strategic goals, federal and state law and regulations, and accreditation standards.
• Attract, manage, and develop clinical programs teams and promote staff development to support professional growth and operational effectiveness. Provide timely feedback and coaching to employees to ensure continuous development to meet current and future needs of the business.
• Represent department, programs, and clinical priorities with internal executive management and key external stakeholders.
• Lead the planning of resources and systems to support implementation of Premera's clinical program strategy and operations.
• Oversee the development and ongoing measurement of operational metrics and reports.
• Coordinate work effort with Director of Clinical Programs and colleagues of multiple teams to achieve organizational efficiency and effectiveness.
• Collect, analyze, maintain, and report data on high-risk members, contractual requirements, performance guarantees, outcome measures, resource utilization, and operational metrics.
• Act as the liaison to third party organizations that support Premera's Clinical Program activities ensuring integration between programs.
• Lead and maintain a culture of continuous improvement that positively contributes to the achievement of Premera's goals.
• Lend clinical and business expertise to support business needs.
• Develop and manage department budget(s).
• Lead, support, or participate on special projects, committees or task forces as assigned.

What you’ll bring:

• Bachelor's Degree in a business or healthcare related field or (4) years of experience in one of those areas. (Required) Bachelor’s Degree in nursing or Master’s Degree in behavioral health services preferred.
• Current Washington or Multistate/Compact licensed registered nurse, or licensed mental health professional. (Required)
• (7) years of health plan industry experience or business/operational experience. (Required)
• (5) years of progressive management experience including experience managing multifunctional teams in multiple locations. (Required)