What are the responsibilities and job description for the Medicare Program Coordinator Nurse Healthcare Specialist position at Providence RN?
Job Summary:
The Clinical Program Coordinator RN will be responsible for coordinating care, managing cases, and overseeing care management services for our members. This role requires excellent communication skills, attention to detail, and a commitment to delivering high-quality patient care.
Key Responsibilities:
- Coordinate care for patients with complex needs
- Manage cases and develop individualized care plans
- Collaborate with medical staff to manage medical expenses and improve access to quality care
- Provide nurse education, care coordination, and general assistance with daily functional needs
About Providence Health Plan:
We are a leading provider of healthcare services, dedicated to delivering whole-person care to our patients and their families. Our team is passionate about making a positive impact on the lives of those we serve.
Requirements:
- 5 years of clinical nursing experience
- Experience working with physicians in collaboration and management of patient care
- Current unencumbered Registered Nurse License in state of residency
Preferred Qualifications:
- 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
- Case Management Experience (e.g., Triage and Referral, Transition of Care Planning, Discharge Planning, Coordination of Outpatient Care)
- Utilization Management Experience (e.g., Concurrent Review, Prior Authorization, Medical Audits, Appeals or Delegation)
- Experience working in a health plan, medical insurance plan, or similar work environment
- Current nursing experience in chronic pain management, cardiology, endocrinology, pediatrics, obstetrics, oncology, respiratory, health education
Benefits:
We offer a comprehensive benefits package, including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources, and much more.
