Providence RN Case Manager - Neurological Specialties in Portland, Oregon
Providence is calling a Case Manager - Neurological Specialties West (1.0 FTE, Days) to Oregon Clinical Programs in Portland, OR.
We are looking for a Care Manager - Neurological Specialties West who will be Care Management is designed to support the patient and practitioner in medical management through the continuum of care. Key services include screening and assessment for medical, psycho-social, and economic needs, transitional planning; assuring appropriate access, level of care and continuity of care; care coordination; education; community referrals and ongoing monitoring for plan effectiveness and continued need of services.
In this position, you will:
Identify and screen for risk, psychosocial needs and utilization patterns.
Apply screening criteria and guidelines that validate/support services requested.
Promote and utilize clinic policies, procedures, tools and reports.
Assessment of patient in relationship to disability, medical diagnoses, psychosocial status, support systems, resources and benefits.
Identify patients who need skilled care services and medical equipment/supplies.
When indicated, obtain and interpret insurance information to patients and families and practitioners. Advocate and refer to health plans for benefit exceptions.
Demonstrate respect for the patient by honoring their right of self-determination.
Actively support measures that promote effective use of resources. Incorporate this into daily work by identifying most appropriate and cost efficient types of services.
Identifies other resources to address financial shortfalls as needed.
Coordination and Communication:
Link patient to appropriate PHS or community resources.
Coordinate, with PHS organizations and community resources when appropriate, multiple details of transitional/care management plan.
Identify opportunities regarding alternative delivery and funding sources for patient.
Provide appropriate education for the patient and family regarding community services and support systems.
Reinforce medical regimen, clinical paths and practice guidelines.
Record all information and maintain all "paperwork" required. Collect, interpret and provides statistical data as required.
Document medical necessity and plan for transition, care coordination and continuity.
Utilize current procedures, document care management goals, interventions, progress and outcomes.
Maintain confidentiality of patient/member records per PHS policy.
Consistently document services according to coding and billing practice guidelines.
Monitors effectiveness of plan and adjusts interventions appropriately.
Track ongoing care coordination and assistance needs, access and utilization patterns.
Actively participates in investment analysis of the Care Management Program within Physician Enterprise.
Consults with physician and interprets access, continuity, coordination and home care needs of patient.
Informs providers and payors of patient status and service needs; consults with them on modification of care plan and financial arrangements.
Promotes teamwork and collaboration with other team members.
Participates, when asked, in clinic staff meetings and committees and community-based initiatives.
May be required to provide care management services in different settings.
Actively supports and may facilitate continuous quality improvement activities.
Maintains, updates and actively improves care management skills, including identifying high risk individuals, care coordination, transition planning and implementation, documentation and evaluation of effectiveness, chronic disease interventions and issues, teamwork, physician communication, process improvement, knowledge of community resources.
Required q ualifications for this position include:
Bachelor's Degree in Nursing or Social Work or related field may be considered
3 years relevant healthcare experience in the following areas:
Social Services/Mental Health/Chemical Dependency
Applicable licensure in State of Oregon
Preferred q ualifications for this position include:
Master's of Science in Nursing or Social Work
Experience in physician office/clinic and community health
1 year related experience in PHS
About Providence in Oregon
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. 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.
Job Category: Case Management
Req ID: 274671