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Wellmark Blue Cross Blue Shield Director of Care Teams (Registered Nurse) in Des Moines, Iowa

Job Summary

Help us lead change and transform the member experience

The health care industry is changing, and Wellmark is working to help change it for the better. We recognize that our members deserve health care with a focus on quality. We also recognize that health care is complex. We’re embarking on a journey to help our members use and navigate the health care system in order to help them make clear, informed decisions, and we’re also ensuring that we take a team-centric approach when working with and in support of our members. The work that our diverse business and care teams are doing in collaboration with our health care partners will create these changes, all while working to minimize health care costs.

Use your strengths as our Director of Care Teams

In this key leadership role, you will execute the strategy , tactical plans and provide direction to leaders of integrated care teams (clinical and non-clinical) that provide personalized, holistic, care management through a dedicated Care Manager nurse supporting the member and family unit. You will lead a seamless, efficient, and effective approach within/across care teams, helping members use and navigate the health care system with a focus on improving outcomes and cost management while ensuring optimal member engagement and experience. You will also lead and support programs and strategic initiatives on behalf of Health Services in collaboration with partners across Wellmark and the provider community.

As a leader of others, you will directly impact the success, growth, and development of team members by setting clear expectations, coaching to each team member’s strengths, and fostering a team-centric work environment. Being a role model in behaviors that demonstrate Wellmark’s Leader Success Expectations and inclusion are essential. Our strongest candidates are mission driven – they believe health care and the member experience can be better, and they are passionate about finding new ways to influence this work. They are also skilled strategists who enjoy ensuring complex operations run smoothly.

Qualifications

Required:

  • Completion of an accredited RN degree program.

  • Active and unrestricted Registered Nurse (RN) license; individual must be licensed in the state in which they reside.

  • Certified Case Manager (CCM). Must attain the certification within 24 months of hire.

  • 7+ years of health plan, clinical operations or related experiences that reflects:

  • Increasing levels of accountability and a track record of success leading complex clinical programs/projects.

  • Effective strategic planning; understands long-range objectives and develops the strategies and actions required to achieve results.

  • Broad knowledge of health services.

  • 4+ years of diverse clinical experience (e.g. acute care, outpatient, home health, etc.) that reflects 4+ years of direct clinical care to the consumer; and the proactive management of complex cases or care plans.

  • Demonstrated leadership experience, including building/developing high performing teams. Establishes clear goals/expectations and motivates teams to achieve success.

  • Demonstrates passion for member advocacy, service excellence, and quality member/patient care.

  • Very strong change management skills. Creates a clear view of future state and inspires others to advance the vision.

  • Effective critical thinking, problem solving, and research skills; analytical and uses data to inform decisions.

  • Strong interpersonal skills, with the ability to effectively facilitate meetings, resolve conflict, build consensus, establish rapport and collaborate effectively across departments, internally and externally, and at all levels within an organization.

  • Exceptionally strong written and verbal communication skills. Demonstrates strong executive presence and the ability to deliver a variety of messages to diverse internal/external audiences.

  • Forward thinking, proactive, and a thoughtful approach to initiative prioritization; skilled at moving from strategy into tactics and operations.

  • Creative thinker who drives the identification of continuous improvement opportunities.

    Preferred:

  • Master’s degree in nursing or related field.

  • Involvement in transformational health care initiatives/projects.

JOB ACCOUNTABILITIES

a. Set the vision and provide strategic direction and daily leadership to leaders of care teams and care team members that align and support Wellmark, divisional, and department strategy and goals centered around improving member outcomes, health care cost management and optimal member engagement and experience. Continually seek opportunities to add value and differentiate services offered in Health Services. b. Form the structure and environment where all clinical and nonclinical team members perform work matched to their licenses, strengths, skills, and abilities. Ensure teams support the member at every stage of their health care journey. Proactively address and resolve issues, tailor outreach based on the member or client needs, and coordinate efficient and effective use of health care services and resources to support the best outcomes and cost management. c. Provide daytoday leadership of human resources, primarily focusing on leader and employee coaching, development, performance improvement, coordination and budgeting for multiple staff centered around care team functions/service. Drive and produce results that are effective, accurate, and timely. Align work with department strategy and be on target to meet member, busines and stakeholder needs. d. Lead and is responsible for performance and outcomes of the care teams while utilizing data and analytics to drive performance. Place emphasis on individual and care team performance to support improved member outcomes, cost management and optimal member experience. Continuously use data to make decisions while aligning with department strategy and performance improvement plans. e. Serve as a clinical resource subject matter expert for leaders and care team members and provide guidance in working through escalated and complex care situations. Ensure processes and programs are focused on holistic coordination of care that are efficient and effective. Coordinate and collaborate with other clinical and nonclinical teams/business areas i.e. Pharmacy, Medical Directors, Customer Service, Customer Care Team, Claims, Legal to ensure a seamless member engagement and experience while continuously supporting the member through their health care journey. f. Support and participate as the subject matter expert in clinical discussions with stakeholders, clients and providers regarding concurrent stays, admissions, discharges, transitions of care, to aide in solving complex member care issues. Collaborate and participate in joint educational sessions and presentations with stakeholders and customers representing Health Services. g. Ensure that all Health Services policy standards and business processes comply with regulatory and statutory and accreditation standards, align with corporate values, and support and enhance the care team functions and quality of healthcare services. Ensure policy is based on accepted standards of care. h. Other duties performed as assigned.

LocationUS-IA-Des Moines

Job ID 214545

Category Leadership

Requires Non-Compete? Yes

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