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, Medicare who will:
- Provide care coordination, case management and care management services to Providence Health Plans(PHP) members
- Care coordination services include: disease management programs, including educating, motivating and empowering members to manage their disease
- Case management services include: triage and referral, transition of care planning, end of life care planning, other acute and catastrophic case management These services are offered to members and their families who have acute and complex health care needs; members with chronic conditions at risk for poor health outcomes and members who are terminal and nearing end of life
- 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
We welcome 100% remote work for residents who reside in one of the following areas:
- Oregon
- Clark County in Washington State
Required qualifications for this position include:
- 5+ years clinical nursing experience
- Experience working with physicians in the collaboration and management of patient care
- Current unencumbered Registered Nurse License in state of residency
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
- Medicare: Insurance business operations experience
- 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: cardiology, endocrinology, pediatrics, obstetrics, oncology, respiratory, health education
Why Join Providence?
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.
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.The amounts listed 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.
Check out our benefits page for more information about our Benefits and Rewards.
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