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We apologize for the inconvenience but the job you are looking for has been filled or it has been removed by the recruiter. For your reference, the original listing is shown at the bottom of this page.
Listed below are the top 10 out of 40 listings that are in the same industry and location as the job you were looking for. To see more than 10 listings, click here to search similar jobs in Durham, NC
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Raleigh NC
review of coded inpatient medical records to validate... entry of information obtained during Hospitalist medical record review and PwC SMART review worksheets. 1......
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Durham NC
team of elite user experience professionals works collaboratively with the business and technology teams... ability to lead, and work as part of a creative team......
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Durham NC
Vice President, ACNO, Medical Director and other key... Provide coaching and feedback on performance to Team Leaders and advanced clinical practice staff and......
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Raleigh NC
patient care services. Experience Requirements : Prefer two years acute care medical/surgical experience -or- one year critical care experience. Education......
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Raleigh NC
of patient care services. Experience Requirements : Prefer one year clinical medical/surgical experience or one year experience in critical care. 2-3 years......
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Cary NC
of patient care services. Experience Requirements : Prefer one year clinical medical/surgical experience or one year experience in critical care. Education......
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Raleigh NC
player on an integration team? If you answered yes... to work efficiently together Consult with SAS R&D teams to provide Teradata specific expertise, including......
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Raleigh NC
SAS R&D teams to be the first line of technical interface, primary technical spokesperson for Aster Data within SAS Liaise with Aster Data R&D teams to support......
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Research Triangle Park NC
global medical technology company that develops, manufactures, and sells medical devices, instrument... and lead interdisciplinary teams. Excellent......
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Raleigh NC
Well Care Benefits Include: -Flexible hours -Competitive Pay -Referral Bonus -80% Employee Paid Medical/Dental -401K with Company Match -Paid mileage -PTO...
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To view more listings click here to search Insurance Jobs in Durham, NC
For your reference, we have included the original job posting below.
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| Job Number: | 25736087 | | Company Name: | BlueCross BlueShield of North Carolina | | Job Location: | Durham, NC US | | Job Category: | Insurance |
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Team Lead, Medical
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AutoReqId 8398BR
Job Title Team Lead, Medical
Business Function Nursing and Healthcare Professionals
Department MHP Operations-State
Position Location Durham
Major Responsibilities Leads teams by encouraging them to take ownership of their work processes and understand their role within the company. Helps teams to understand high-level business objectives and how their work is essential to the achievement of these objectives. Provides coaching and focuses on career development for team members. Manages performance of team members and delivers timely and appropriate performance feedback and training. Models our customer promise by simplifying processes, assisting customers, and empowering employees.
Requirements Education
RN, LPN, PA, or FNP degree with valid NC license.
Team Leads that supervise Case Managers must be RN's.
For RN, PA, or FNP, 3 years previous clinical nursing experience, or 3 years in a health insurance industry such as Utilization Management processes, managing health conditions, understanding medical criteria, medical guidelines, medical policy, and NCQA and DOI, Medicare/CMS regulations. If LPN, 5 years previous clinical nursing experience, or 5 years in a health insurance industry such as Utilization Management processes, managing health conditions, understanding medical criteria, medical guidelines, medical policy, and NCQA and DOI, Medicare/CMS regulations.
Knowledge of Windows and Microsoft Office required.
FEP:
Team Leads that supervise Case Managers: Certified Case Manager (CCM) certification is required within 2 years of obtaining the role of Team Lead. Team Leads in existence as of 4/1/10 will have two years to obtain certification.
Additional Critical Skills & Knowledge Needed for Job . Keeps abreast of medical knowledge and care patterns, regulatory and governmental rules and regulations, and of BCBSNC policies related to care management. Takes ownership of personal development and continuous learning by networking with peers, joining relevant associations, staying abreast of current industry trends, etc.
. 2 years of experience in a supervisory, leadership, precepting, or training role in a health care delivery system.
. Experience in a health insurance environment.
. Incumbent is required to learn specifics of technical/operational area within 6 months of hire date.
. Medical management and sound decision making skills.
. Must possess the ability to build effective working relationships with providers, members, employers, and BCBSNC staff.
. Knowledge of medical policy and healthcare claims administration.
. Commitment to high quality customer service.
. Consistent demonstration of leadership behaviors required (i.e. training, mentoring, assisting peers with issue resolution).
. Demonstrated success in coaching, giving constructive feedback, and developing employees.
. Demonstrated ability to promote and support teamwork and team decision-making.
. Ability to build consensus and form partnerships with various levels of staff within and across an organization.
. Excellent negotiation, decision-making, and relationship-building skills.
. Excellent oral and written communication skills.
. Demonstrated analytical thinking skills.
. Ability to identify issues and recommend and implement solutions.
. Ability to make sound and independent business decisions in often high-pressure situations.
. Experience in resolving employee relations issues and applying Human Resource policies.
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