What are the responsibilities and job description for the Care Management Clinician - Lane County position at PacificSource?
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PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.
Diversity and Inclusion : PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.
Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client's health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes. Clinicians incorporate the essential functions of professional case management concepts to enhance patients' quality of life and maximize health plan benefits. These functions include but are not limited to : coordination and delivery of healthcare services, consideration of physical, psychological, and cultural factors, assessment of the patient's specific health plan benefits, and additional medical, community, or financial resources available.
Qualified candidates must be acceptable to one of the following available work schedules :
- Tuesday - Saturday 8 : 00am to 5 : 00pm
- Sunday - Thursday 8 : 00am to 5 : 00pm
Essential Responsibilities :
Supporting Responsibilities :
SUCCESS PROFILE
Work Experience : Minimum of three (3) years of clinical experience, including case management. Insurance industry experience preferred.
Education, Certificates, Licenses : Clinical Social Worker, Licensed Professional Counselor, or Licensed Independent Clinical Social Worker with unrestricted license required in current state of residence. OR Registered Nurse with current appropriate unrestricted state license based on line of business : Commercial and Medicare : Oregon, Idaho or Montana, and Washington; Medicaid and DSNP : Oregon. Certified Case Manager Certification (CCM) as accredited by CCMC (The Commission for Case Management) strongly desired at time of hire. CCM certification required within two years of hire.
Knowledge : Knowledge of health insurance and state mandated benefits. Experience and expertise in case management practice including advocacy, assessment, planning, communication, education, resource management and service facilitation. Ability to deal effectively with people who have various health issues and concerns. Knowledge and understanding of contractual benefits and options available outside contractual benefits. Knowledge of community services, providers, vendors and facilities available to assist members. Ability to use computerized systems for data recording and retrieval. Assures patient confidentiality, privacy, and health records security. Establishes and maintains relationships with community services and providers. Maintains current clinical knowledge base and certification. Ability to work independently with minimal supervision.
Competencies
Adaptability
Building Customer Loyalty
Building Strategic Work Relationships
Building Trust
Continuous Improvement
Contributing to Team Success
Planning and Organizing
Work Standards
Environment :
Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Skills :
Accountability, Collaboration, Communication (written / verbal), Flexibility, Listening (active), Organizational skills / Planning and Organization, Problem Solving, Teamwork
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business :
Physical Requirements : Stoop and bend. Sit and / or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer : This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
