Job Information

Providence Care Management Clinical Support Coordinator (Remote: SW WA / OR) 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

  • Work in a team environment focusing on phone outreach, care coordination and clinical support of the case & disease and medical management programs

We welcome 100% remote work for residents of Southwest Washington and Oregon.

Primary Responsibilities:

  • Perform phone 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:

  • Motivational Interview training: Within 6 months of hire

  • 3 years of experience working within one of the following areas of specialty (experience can be within one specialty or a combination of specialty's): Certified Medical Assistant (CMA) or Certified Nursing Assistant (CNA) -OR- 3 years of equivalent experience working in a clinical, managed care or care management setting

Preferred qualifications for this position include:

  • Bachelor's Degree in a Health related field of study -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

  • Experience with Lean principles, stewardship &development of programs and partnerships within a challenging and dynamic healthcare environment

  • Driving may be necessary as part of this role. Caregivers are required to comply with all state laws and requirements for driving. Caregivers will be expected to provide proof of driver license and auto insurance upon request. See policy for additional information.

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.

About the Team

Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment.

We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.

We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.

Requsition ID: 127388
Company: Providence Jobs
Job Category: Care Management
Job Function: Clinical Care
Job Schedule: Full time
Job Shift:
Career Track:
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.