Clinical Program Coordinator RN - Remote at Providence Health Care, Inc

Portland, Oregon, United States -

Full Time

Start Date

Immediate

Expiry Date

12 Jun, 26

Salary

82.58

Posted On

14 Mar, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Nursing, Care Coordination, Case Management, Triage, Referral, Transition Of Care Planning, Acute Case Management, Catastrophic Case Management, Nurse Education, Health Plan Benefits Management, Utilization Management, Concurrent Review, Prior Authorization, Medical Audits, Appeals, Maternity

Industry

Hospitals and Health Care

Description

Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence Health Plan is calling a Clinical Program Coordinator RN who will: * Support the commercial insurance based line of business for cases including but not limited to: Maternity, Pediatrics, Transplant, Pain Management * Provide care coordination, case management and care management services to Providence Health Plans (PHP) members * Case management services include: triage and referral, transition of care planning, acute and catastrophic case management * Care management services include: nurse education, care coordination and general assistance with managing day to day functional needs; assisting with the management of member health plan benefits and offering assistance finding alternative services when benefits are exhausted * Work within the health plan framework of managing medical expenses * Work to improve access and quality care to our members Providence Health Plan welcomes 100% remote work for applicants who reside in the following areas: * Oregon Please note the following important details regarding this role: * This posting is for multiple openings of a Clinical Care Coordinator RN * This position is affiliated with Providence Health Plan and will be tied to a location and compensation range in Beaverton, Oregon * This position requires for you to have a current home address in either the State of Oregon or Washington * Work Shift: Monday - Friday * Work Hours: 8am - 5pm Required qualifications for this position include: * 5+ years of clinical nursing experience * Experience working with physicians in the collaboration and management of patient care * RN License: State of Oregon Preferred qualifications for this position include: * Bachelor's Degree in Nursing or Health Education * Within six months of hire date: Current unencumbered Registered Nurse License in Washington State * Case Management Experience (EX. Triage and Referral, Transition of Care Planning, Discharge Planning, Coordination of Outpatient Care) * Utilization Management Experience (EX. Concurrent Review, Prior Authorization, Medical Audits, Appeals or Delegation) * Experience working in a health plan, medical insurance plan or another similar work environment * Current nursing experience in the following areas: chronic pain management, cardiology, pediatrics, maternity Why Join Providence Health Plan? Our best-in-class benefits [https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.providenceiscalling.jobs%2Frewards-benefits%2F&data=05%7C02%7Cdeeann.sarro1%40providence.org%7Cf576c1fc1e19416e1b2408dc2415fdb0%7C2e3190869a2646a3865f615bed576786%7C0%7C0%7C638424924066313496%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=2F3YWasACMeyDqyS2UFh%2BYIqf7vAbqgBT0Ucvr1LLpg%3D&reserved=0] 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 [https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.providenceiscalling.jobs%2Fmission-core-values%2F&data=05%7C02%7Cdeeann.sarro1%40providence.org%7Cf576c1fc1e19416e1b2408dc2415fdb0%7C2e3190869a2646a3865f615bed576786%7C0%7C0%7C638424924066325146%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C0%7C%7C%7C&sdata=i%2FqkOEUIWUrog65%2B%2F8md1bnrBSm0bPQA%2FvRLsULQQ0c%3D&reserved=0] of caring for everyone, especially the most vulnerable in our communities. 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. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits [https://providence.jobs/benefits/]. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act [https://s3-us-west-2.amazonaws.com/images.provhealth.org/HR-onboarding/LA_County_Fair_Chance_Ordinance_2024.pdf]. 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. Providence is proud to be an Equal Opportunity Employer [https://www.providenceiscalling.jobs/eeo/]. 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 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. We believe diversity [https://providence.jobs/diversity/] makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

Responsibilities

The Clinical Program Coordinator RN will support the commercial insurance line of business for cases including Maternity, Pediatrics, Transplant, and Pain Management. This role involves providing comprehensive care coordination, case management, and care management services to Providence Health Plan members.