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Clinical Care Manager RN I

Samaritan Health Services

Samaritan Health Servicessamaritanhealthservices.com

Clinical Care Manager RN I

Corvallis, OR
Posted today

About the job

Samaritan Health Plans offers Medicaid, Medicare, and commercial plans. This RN Clinical Care Manager role focuses on care assessment, coordination, and support for diverse patient populations.

Requirements

  • Oregon RN license
  • One year clinical experience
  • Experience in healthcare systems
  • Familiarity with electronic documentation
  • Knowledge of managed care

Qualifications

  • BSN preferred
  • Ability to communicate effectively
  • Confidentiality knowledge
  • Critical thinking skills
  • Cultural sensitivity

Full job description

Summary

Hybrid position that will require onsite presence at our clinics to work with patients.
  • JOB SUMMARY/PURPOSE

    • Assesses, plans, implements, coordinates, monitors and evaluates options and services to meet an individual’s health needs. Applies knowledge of applicable regulations, identifies resources (internal or community partners) and eliminates barriers where possible. Provides care management interventions and seamless support across transitions of care. Works with cases that have a low to moderate level of service intensity.

  • DEPARTMENT DESCRIPTION

    • Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage and Commercial Large Group plans. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.

  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Current unencumbered Oregon RN License required. BSN preferred.
    • One (1) year clinical nursing experience required.
    • Experience or training in the following required:
      • Health care delivery systems and/or managed care patients.
      • Computer applications including electronic documentation (e.g., MS Office, EPIC, Clinical Care Advanced).
    • Experience in the following preferred:
      • Case management.
      • Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Communication - Effective written and verbal communication skills provided to members, providers and organization staff. Able to tactfully discuss issues, and listen to and understand complex information/situations. Ability to apply motivational interview techniques when working with members. Proactively resolve conflicts in positive and constructive manner.
    • Confidentiality - Knowledge of State and Federal (HIPAA) laws pertaining to confidentiality of protected health information. Ability to comply with laws and maintain confidentiality of patient information.
    • Critical Thinking - Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions in a member centric manner.
    • Social Perceptiveness - Ability to work with a diverse population from pediatrics to geriatrics. Basic understanding of age-related differences in caring for and/or communicating with members and caregivers. Possess personal sensitivity to the needs and experiences of others and a non-judgmental attitude towards persons of differing standards, values, lifestyles, and ages.
    • Knowledge of Medicare and Medicaid rules and regulations and health plan benefit structure and policy. Ability to appropriately apply evidence based clinical practice and criteria to authorization requests.
  • PHYSICAL DEMANDS

    • Rarely
      (1 - 10% of the time)

      Occasionally
      (11 - 33% of the time)

      Frequently
      (34 - 66% of the time)

      Continually
      (67 – 100% of the time)

      CLIMB - STAIRS

      LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs

      LIFT (Knee to chest: 24"-54") 0 – 20 Lbs

      LIFT (Waist to Eye: up to 54") 0 - 20 Lbs

      CARRY 1-handed, 0 - 20 pounds

      BEND FORWARD at waist

      KNEEL (on knees)

      STAND

      WALK – LEVEL SURFACE

      ROTATE TRUNK Standing

      REACH - Upward

      PUSH (0 - 20 pounds force)

      PULL (0 - 20 pounds force)

      SIT

      CARRY 2-handed, 0 - 20 pounds

      ROTATE TRUNK Sitting

      REACH - Forward

      MANUAL DEXTERITY Hands/wrists

      FINGER DEXTERITY

      PINCH Fingers

      GRASP Hand/Fist
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