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Blue Cross Blue Shield of Michigan Director - Care Management - CAR0001T in Detroit, Michigan

Departmental Summary/Preferences:This position reports to the Vice President of Care Management in the division of Health Plan Business. The Director of Care Management leads a multi-disciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and social needs.The Director works collaboratively as part of the CM leadership team to deliver all aspects of the CM program including enhancement, implementation, performance management, evaluation, product strategy and customer support. They also act as a liaison to other internal departments such as medical affairs, utilization management, audit, customer service and group sales.This position is responsible for the day to day operations and human resource management of a multi-disciplinary team including RN Care Managers, Social Workers, Pharmacists, Dietitians, Behaviorists, and non-clinical support staff.Examples of everyday tasks include;Lead and direct activities of multiple regional teams, including but not limited to planning, staff development, problem solving and communications.Establish business goals and objectives incorporating operational metrics and program evaluations for multiple units.Manage professional exempt, non-bargaining unit employeesLead and support continuous quality improvement.Manage and develop business unit leadership.Provide effective/efficient solutions to complex business problems.Provide high level oversight and leadership to multiple business units and lead change effectively.Ensure that accreditation and/or regulatory compliance are met.Deliver an effective employee training program incorporating the elements of design, development and evaluation.Interface with HR departments, including but not limited to; HR Business Partner, Recruitment, Compensation, Employee Relations and Employee Services.Collaborate and support the design and development of program clinical pathways.Collaborate and support program evaluation design including specifying indicators of program success, defining the scope of the evaluation.Lead day-to-day management of multiple programs initiatives by establishing project plans and objectives to ensure team goals are met."Qualifications"Departmental Requirements:7 to 10 years experience working in a health insurance plan, health provider organization or public health or community-based agency in a similar capacityFive (5) or more years experience in developing and evaluating clinical programsFive (5) to ten (10) years experience in a leadership roleProven ability to lead a large clinical team to deliver care management programs efficiently and effectivelyDemonstrated ability to present CM program description and results to external employer group customersProven ability to successfully navigate complex projects and initiatives in a large corporate organizationIntermediate to advanced computer skills and experience with Microsoft Word, Excel and OutlookBachelor's Degree in Nursing with a current MI Nursing licenseCertification in Case Management (CCM) or eligible to obtained within 12 months of hireCorporate Requirements:Responsible for planning, organizing, directing, controlling and leading multiple business unitsSet vision and identify strategic direction for the business units. Support corporate goals and objectivesDirect activities of multiple functional areas, including but not limited to planning, staff development, problem solving and communicationsEstablish for the business unit goals and objectives that support continuous quality improvementManage and develop business unit leadershipProvide

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