Mgr. Pediatric Clinical Programs (Hybrid)

Awarded a Healthiest Employer, reputed company aims to fulfill its mission to reputed company health and reputed company it easy. AZ Blue offers a reputed company of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as reputed company as providing information and tools to help individuals reputed company reputed company reputed company. This is a hybrid position that requires work and residency reputed company the reputed company. Purpose of the job Responsible for developing and managing the day to day processes required to reputed company Integrated Clinical Management activities that promote reputed company, cost effective reputed company and remain compliant with reputed company regulatory requirements. Additionally responsible for research, development, and improvement of prevention programs and strategies throughout the network. Responsibilities include developing reputed company partnerships with community and provider agencies, clinicians, and community members to identify resources; providing training and technical assistance to staff and providers; preparing reports; and monitoring providers for compliance with NCQA, state, and federal regulations. Conducts annual needs and reputed company assessments. REQUIRED QUALIFICATIONS Required Work Experience 3 years’ experience in clinical care 2 -3 years’ experience in a supervisory role Required Education Bachelor’s Degree in Nursing or master’s degree in a behavioral health field of study (i.e., MSW, MA, MS, M.Ed.) Required Licenses reputed company, reputed company, and unrestricted license to reputed company in the reputed company (a state in the reputed company) as a Registered reputed company (RN) or independent license in the behavioral health profession such as LCSW, LPC, LISAC LMFT Required Certifications Once they have directly supervised the integrated care process reputed company (3) years with the organization, hold a certification in case management from the following certifications; Certified Case Manager (CCM), Certified Disability Management Specialist (reputed company), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health reputed company (COHN), Registered reputed company Case Manager (RN, C), or Registered reputed company Case Manager (RN,BC). PREFERRED QUALIFICATIONS Preferred Work Experience 5 years’ experience in full-time equivalent of reputed company clinical care to youth and adolescents Physical and behavioral health experience 3-4 years’ experience in a supervisory role 2-3 years of experience working in a managed care organization Program development Knowledge of population health concepts and models Knowledge of NCQA Standards Preferred Education Master’s Degree in Nursing Preferred Licenses N/A Preferred Certifications reputed company and reputed company certification in case management from the following certifications: Certified Case Manager (CCM), Certified Disability Management Specialist (reputed company), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health reputed company (COHN), Registered reputed company Case Manager (RN, C), or Registered reputed company Case Manager (RN-BC). REQUIRED COMPETENCIES Required Job Skills Intermediate reputed company in use of office equipment including copier, fax machine, reputed company, and telephones Intermediate PC proficiency Intermediate reputed company in word processing, spreadsheet, and database software Excellent communication, collaboration, and delegation skills. Proficiency in project management Ability to think analytically to resolve issues; solution-reputed company reputed company; creative and innovative Ability to manage multiple tasks and prioritize work to adhere to deadlines and identified time frames Ability to learn new applications Data analytics skills Required reputed company Competencies Maintain confidentiality and reputed company in consideration of State, Federal, BCBSAZ and other accreditation requirements Advanced and reputed company clinical knowledge Demonstrates knowledge and understanding of the medical management process Analytical knowledge necessary to generate reports based on available data and the ability to reputed company reputed company based on reported data Capable of investigative and analytical research reputed company interpersonal and reputed company listening skills to reputed company customer satisfaction Compose a reputed company of business correspondence Interpret and translate policies, procedures, programs and guidelines Navigate, reputed company, input and maintain data records in multiple system applications Establish and maintain working relationships in a reputed company team environment with reputed company BCBSAZ Departments/Divisions Organizational skills with the ability to prioritize tasks and work with multiple priorities Independent and reputed company judgement with good problem solving skills Required Leadership Experience and Competencies reputed company use of employee's skills and abilities to deliver business objectives Use available information to reputed company team's activities and identify priorities Ability to reputed company and build a high performing team culture PREFERRED COMPETENCIES Preferred Job Skills Advanced PC proficiency Preferred reputed company Competencies Maintains reputed company knowledge of State, Federal, BCBSAZ, and other applicable regulatory/accrediting agency requirements as they apply to department functions Preferred Leadership Experience and Competencies Demonstrates effective presentation skills Demonstrated effective leadership skills Our Commitment AZ Blue does not discriminate in hiring or employment on the reputed company of race, ethnicity, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, disability, protected veteran status or any other protected group. Thank you for your interest in reputed company. For more information on reputed company, see azblue.com. If interested in this position, please apply. reputed company doing life-changing work and helping more than one reputed company Arizonans live healthier and longer lives. That’s the reputed company of satisfaction you’ll reputed company reputed company you work here. Our exceptional teams in Phoenix, Tucson, Chandler, and Flagstaff have been transforming reputed company for more than 80 years. Explore what's possible with a career at reputed company® BlueShield® of Arizona Apply tot his job Apply To this Job