Team Leader, Clinical Teams

Job Description

What You'll Do

• Manages day-to-day business area activities, provides leadership, coaching and training to team members, sets clear goals and expectations and manages performance as needed.
• Creates a positive work environment that fosters teamwork, empowerment, accountability, and superior customer service.
• Acts as a medical and technical resource for team members and other departments, providing assistance/guidance on clinical and/or system issues, benefits, and work processes and procedures specific to departmental needs.
• Identifies trends, determines root causes, and takes action to resolve issues and initiate necessary process and procedural changes to improve internal and external customer satisfaction.
• Ensures all departmental and clinical reports and necessary reviews are completed in a timely manner.
• Maintains accountability for achieving targeted results and communicates regularly with organization leadership regarding workloads, issues, projects, monitoring of team performance and staffing needs.
• Leads special projects and/or represents the department on corporate projects that require independent, sound decision making and broad based understanding of effects on the department as a whole.
• Responsible for the application and compliance with all regulations, standards or other regulatory requirements applicable to departmental operations. Formulates corrective action plans to address any areas of non-compliance.
• Must maintain current knowledge in applicable clinical areas, standards and certifications (where required) and keep abreast of trends related to the health insurance industry (i.e. CPT, HCPCS, ICD-9, and ICD-10 coding, etc).
• Facilitates meetings and conducts formal presentations for staff and/or cross functional or customer groups as needed.

What You'll Bring (Hiring Requirements)

• RN, PA, FNP or other APN certification
• 5+ years of relevant experience
• Must have valid NC license or multistate compact license
• Prior experience leading people, projects or programs
• For some roles, must be Certified Case Manager (CCM) upon hire or within 2 years

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Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.