Clinical Case Manager at Bright Health

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ABOUT THE ROLE
Bright Health’s Case Management team supports plan members that are impacted by significant health and/or lifestyle events, situations or conditions. Clinical Case Managers assist Bright members by coordinating care across multiple clinical providers, assist with establishing social support services, and/or providing education for self-care and monitoring practices. These services are guided by established policies and procedures, developed by Bright’s Clinical Programs team. This role embodies a philosophy that maintains focus on improving members’ health and supporting a positive service experience. The Case Manager will ensure all related initiatives meet all applicable state and/or federal regulatory requirements in addition to corresponding URAC standards. 

YOUR RESPONSIBILITIES

  • Work with members, their providers and applicable care teams to develop personal care plans associated with medical, behavioral and/or social situations.
  • Conduct outbound interventions to advance member care plans, coordinate care and close clinical gaps.
  • Collaborate with Provider Relations, Market Management teams and Care Partner representatives in the management of members’ care plans.
  • Participate in the development of operating models to execute clinical program solutions, including but not limited to Complex Case Management, Disease Management and Transitions of Care
  • Collaborate with organizational leaders, including, but not limited to Network Navigation, Product, Clinical Program Management and Market Performance to identify opportunities for service improvement, including further integration with Bright’s Care Partners where appropriate.
  • Provide feedback to Program Management team with respect to program design, efficiency, efficacy and member/provider satisfaction.
  • Support the development and maintenance of standard operating procedures related to corresponding clinical program functions.
  • Participate in, and/or lead the implementation of new care coordination initiatives and/or new market installations
  • Manage individual work-plan and prioritize time to meet key deliverables.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • Bachelor’s Degree in a related field required
  • Three (3) or more years of clinical or case management experience preferred
  • Prior experience with URAC accreditation preferred, but not required

PROFESSIONAL COMPETENCIES

  • Ability to evaluate complicated problems and isolate contributing factors
  • Capable communicator that can interact with others at multiple levels within the organization
  • Leads through influence and example
  • Strong operational mindset and use data to draw insights
  • Thrives on driving results in a collaborative environment

LICENSURES AND CERTIFICATIONS

  • An active, unrestricted Registered Nurse (RN), Licensed Practical Nurse (LPN), or Licensed Clinical Social Worker (LCSW) license is required. 

ABOUT US
 
At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.
 
We’re Making Healthcare Right. Together. 
We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!
 
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
BRIGHT ON!

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Technology we use

  • Engineering
  • Product
    • .NETLanguages
    • C#Languages
    • JavascriptLanguages
    • PythonLanguages
    • SqlLanguages
    • PowerShellLanguages
    • D3JSLibraries
    • ReactLibraries
    • Node.jsFrameworks
    • MongoDBDatabases
    • TSQLDatabases
    • InVisionDesign
    • SketchDesign
    • Lucid ChartDesign
    • JIRAManagement
    • Microsoft ProjectManagement

Location

We are downtown at 515 Congress Avenue, right in the heart of downtown! Tons of restaurants and close to public transportation.

An Insider's view of Bright Health

What’s the vibe like in the office?

The office has a relaxed and laid back vibe but people are very serious about their work - perfect!

Anthony

Data Engineer

What does your typical day look like?

My day is so varied, given how quickly we're growing, which is fulfilling for me. I have a good balance of strategic and tactical work in my day as well as time to focus and time to collaborate.

Jen

VP, Digital

What makes someone successful on your team?

A hard-working team player who thinks first and codes next is likely to learn a lot and quickly become a valuable member of the team. Lots of experience with some of our tooling is always nice, but if someone can't knowledge-share well or responds poorly to code reviews and other requests for collaboration, it'll be a tough fit.

Brian

Software Engineer 3

How do you make yourself accessible to the rest of the team?

Modeling after my manager, I like to provide both regularly scheduled one-on-one meetings, where developers and engineers get to set the agenda. We can talk about career development, design and architecture ideas, industry trends, or traditional HR topics like goal setting. It’s up to them. I also have begun setting regular “office hours.”

Amy

VP & Data Platform Architect

How do your team's ideas influence the company's direction?

We hire smart individuals who thrive on accomplishment and purpose. Our teams are exposed to the bigger picture through constant communication and dialogues – that encourages them to come up with innovative solutions to problems. We've made significant adjustments on our direction in technology and process that were initiated by the team.

Abdullah

VP, Engineering

What are Bright Health Perks + Benefits

Bright Health Benefits Overview

We have 3 different health insurance plans, all through Cigna (HDP, Premium HDP and PPO). We cover the majority of the cost for the employee and some cost for family. We have two dental plans and a vision plan as well. We put 3% of your total earnings into your 401K plan and you are immediately vested in that. We have all the latest technology (Mac or Surface laptops – your choice) to use including standing desks. Fully stocked fridge with snacks and drinks.

Culture
Friends outside of work
Eat lunch together
Daily stand up
Open door policy
Team owned deliverables
Team based strategic planning
Pair programming
Open office floor plan
Diversity
Highly diverse management team
Mean gender pay gap below 10%
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Bright Health employees can contribute up to $3500 annually to their FSA.
Disability Insurance
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Onsite Gym
Retirement & Stock Options Benefits
401(K)
We will put 3% of your total earnings into your 401K plan, even if you don't put anything in. It's a safe harbor contribution.
401(K) Matching
Bright Health provides employees with a 401(k) plan managed by Vanguard. We provide a ‘safe harbor’ non-elective contribution equal to 3% of your compensation, regardless of participation in the p
Company Equity
Performance Bonus
Child Care & Parental Leave Benefits
Generous Parental Leave
We provide up to 6 weeks of parental leave for the primary caretaker. We also provide 2 weeks of leave for the secondary caretaker.
Flexible Work Schedule
Bright Health provides employees with a flexible work schedule that includes Core hours, Flexible start and end times.
Family Medical Leave
Employees who have been with the company for 12 months are eligible for 12 weeks of family medical leave.
Company sponsored family events
Bright Health sponsors family oriented events Annually.
Vacation & Time Off Benefits
Paid Holidays
Perks & Discounts
Casual Dress
Commuter Benefits
Stocked Kitchen
Happy Hours
Happy hours are hosted on occasion.
Fitness Subsidies
Bright Health employees are eligible for discounts on several gym memberships.
Professional Development Benefits
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