Clinical Program Coordinator RN

Providence • Portland, OR

7d • Remote

About The Position

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

Requirements

• 5+ years of clinical nursing experience
• Experience working with physicians in the collaboration and management of patient care
• RN License: State of Oregon
• This position requires for you to have a current home address in either the State of Oregon or Washington

Nice To Haves

• 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

Responsibilities

• 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

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level