Clinical Program Manager-RN (Health Plans)

Samaritan Health Services • Corvallis, OR

1d • $47 - $71 • Remote

About The Position

Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealthPlans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services' self-funded employee health benefit plan. 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. This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin   JOB SUMMARY/PURPOSE The Clinical Program Manager is responsible for executing assigned program(s) that align with organizational goals and meet the needs of employees, customers, and stakeholders. This role leverages clinical expertise and system improvement skills to support assigned programs, ensuring successful planning, implementation, and oversight. The Clinical Program Manager leads all aspects of program development and execution, collaborates with internal teams and external partners, and serves as a subject matter expert across the organization.  

Requirements

• Current unencumbered Oregon RN License required within 90 days of hire.
• One (1) year clinical nursing experience plus four (4) years health plan, case management and/or utilization management 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).
• Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
• Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
• 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.
• Communication and team building - Lead effectively with excellent verbal and written communication. Delegates and initiates/manage cross-functional teams and multi-disciplinary projects.

Nice To Haves

• BSN preferred.
• Master's degree in a related field preferred.
• Experience in the following preferred: Team leadership. Case management. Medicare and Medicaid rules and regulations and health plan benefit structure and policy.

Responsibilities

• Executing assigned program(s) that align with organizational goals and meet the needs of employees, customers, and stakeholders.
• Leveraging clinical expertise and system improvement skills to support assigned programs, ensuring successful planning, implementation, and oversight.
• Leading all aspects of program development and execution
• Collaborating with internal teams and external partners
• Serving as a subject matter expert across the organization.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 5,001-10,000 employees