Job Information

Providence Care Management Clinical Support Coordinator in Beaverton, Oregon

Description

Providence is calling a Care Management Clinical Support Coordinator who will:

  • Be responsible for performing duties in support of the core functional areas of care management and other integrated medical management programs

  • Functions in a team environment focused on telephonic outreach, care coordination and clinical support of the case & disease and medical management programs

We welcome 100% remote work for residents living in SW Washington and Oregon.

Primary Responsibilities:

  • Perform telephonic assessments and care coordination in consultation with Nurse Care Coordinators for members eligible for care management, particularly those with complex and chronic care needs

  • Triage and document calls appropriately per department policies and standards

  • Coordinate care for members needing assistance with accessing health care services, providers, community services, or other resources

  • Collaborate with nursing staff to deliver healthcare education and coordinate care management services for members including high cost, high risk and high utilizing member cases

Additional Responsibilities:

  • Assist in the coordination of discharge services with PHP HCS teams, care providers, or others involved in the member's care

  • Assess and triage care management services

  • Receive and review inpatient and outpatient reports

  • Initiate information system searches for needed documentation and information for case review

  • Employ motivational interviewing skills to engage members and assist with self-management of health & wellness

  • Understand and accurately interpret and communicate members' health care benefits in close collaboration with other HCS and Service Operations staff

  • Track program outcomes against stated policies

  • Receive and triage inquiries regarding quality of care, and care management issues

  • Serve as a liaison and resource to the member, clinical staff and professional staff for problem resolution

  • Assist in developing or revising department policies and procedures, and work flows including quality audits to ensure compliance, efficiency, and productivity metrics are met

  • Assist in prioritizing workload to meet deadlines by using available tools

  • Anticipate patient and providers' needs requiring initiative and flexibility

  • Seek and maintain comprehensive level of industry knowledge of insurance benefits, services, provider networks and internal workflow and functions

Required qualifications for this position include:

  • 3 years' experience as a Certified Medical Assistant (CMA), Certified Nursing Assistant (CNA) or equivalent experience working in a clinical setting, managed care, or care management setting

Preferred qualifications for this position include:

  • Bachelor's Degree in Health related field -OR- a combination of equivalent education and experience

  • Experience in managed care services including Affordable Care Act, Coordinated Care Organizations, Medicare and Medicaid regulations and care or utilization management functions

  • Motivational Interview training; within 6 months of hire

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

About Providence

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

Requsition ID: 111135
Company: Providence Jobs
Job Category: Care Management
Job Function: Clinical Care
Schedule: Full time
Shift: Day
Career Track: Clinical Support
Department: 5018 HCS CASE AND DISEASE GOV PRGM OR REGION
Address: OR Beaverton 3601 SW Murray Blvd

Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.