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, Maternity / Pediatrics 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:
Please note the following important detail regarding this role:
- This posting is for multiple openings of a Clinical Care Coordinator RN, Maternity / Pediatrics
- 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
- Oregon RN Licensure
Preferred qualifications for this position include:
- Bachelor's Degree in Nursing or Health Education
- Upon Hire: Current unencumbered Registered Nurse License in Oregon
- 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 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.
Requisition ID: 321566
Company: Providence Jobs
Job Category: Clinical Administration
Job Function: Clinical Support
Job Schedule: Full time
Workplace Type: Remote
Pay Range: $45.22 - $71.58
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