Employee Health Nurse Salary in Boise, ID

Data & Analytics Outreach Product ManagerRemote within OR, WA, ID or UTJob Description:The Data & Analytics Outreach Product Manager brings extensive data & analytics execution and delivery experience using data platform technologies (e.g. database, storage, access, sharing, interfaces), analysis and measurement (e.g. analytics, data science, business intelligence, reporting) and product methodology (e.g. prospecting, discovery, value proposition, feature selection, user-centric design, cross-functional communication) in order to deliver business value to stakeholders in support of the product vision and company goals. The Data & Analytics Outreach Product Manager will collaborate with the Digital and Marketing teams to effectively utilize Data and Analytics products to identify key member populations, deploy impactful experiences to serve those members, and optimize value creation thru measurement and iteration of experiences.General Functions and Outcomes:• Responsible to drive the product delivery roadmap for data & analytics within the assigned data and business domains.• Responsible for stakeholder engagement and value delivery through Data & Analytics Products.• Responsible for communicating and documenting product requirements cross-functionally with stakeholders and technical teams including data governance, engineering, artificial intelligence, analytics, product, etc.• Partner across and collaborate with a high-performing, high-throughput, Data & Analytics Solutions team, our Business Systems Analysts, and our Business Partners.• Understand company business strategies, goals, and objectives; lead interactions with business partners that identify opportunities for the enterprise to effectively leverage data & analytics to drive measurable business results.• Utilize market knowledge to amplify data & analytics product development opportunities leveraging artificial intelligence, data engineering, data warehousing, and data visualization.• Align with business partners to balance business and technical objectives and manifest these in prioritization of Data & Analytics Product feature development.• Look across the enterprise data & analytics landscape to drive a coordinated offense of tactical execution & sequencing, maximizing outcomes.• Lead the distillation of business requirements into concise, detailed product requirements.• Manage complex product and technical decisions and work with program and engineering to drive development through agile methodology.• Build partnership and alignment with internal and third-party partners to define, refine, and develop product development, launch, and enhancement processes.• Measure and communicate the success of your data & analytics products. Analyze usage and drive improvements to the accuracy and effectiveness of overall platform capabilities.Minimum Requirements• Comfortable at influencing without authority. Capable of taking analytical insights and tying them to effective framing for drive high-quality decisions by our business partners.• Ability to build clear and concise presentations and communicate effectively at every level of the organization.• Experience with data instrumentation, data ingestion, data enrichment, and data syndication in a cloud-based ecosystem.• Experience with data analysis, business intelligence, and data visualization.• Experience eliciting and refining business hypothesis to validate thru data analysis.• Experience with measurement and statistical analysis of behavioral data.• Demonstrated specialization, execution, and delivery of the data & analytics product.• Demonstrated ability to facilitate cross-functional planning sessions (ie Scrum and Squad in agile).• Demonstrated ability to effectively partner across, collaborate with, and inspire teams and individuals, including remote employees.• Ability to negotiate and resolve complex and sensitive issues with diplomacy and persuasiveness.• Expertise using SQL for analysis, analytics, and transformation.• Experience in one or more RDBMS (Oracle, DB2, and SQL Server, etc).• Experience using and developing data for visualization tools (SIGMA, Power BI, Tableau, Open Source, etc.).• Understanding of Cloud Data Warehouses, especially Snowflake, master data management, system integrations, etc.Normally to be proficient in the competencies listed aboveData & Analytics Product Development Lead would have a Bachelor's degree in business, computer science, data science or related field. 10+ years of experience in data engineering, data analytics, and/or business intelligence. 5+ years of product management experience, or equivalent, within a data driven industry: Healthcare, insurance, banking, or related industry experience preferred.Work Environment• No unusual working conditions.• Work primarily performed in office environment.• Travel required, locally or out of state.• May be required to work outside normal hourThe expected hiring range for a Data & Analytics Outreach Product Manager is $132,600-$179,40 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15% . The current full salary range for this role is $124,000 - $203,000Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:medical, dental, and vision coverage for employees and their eligible family membersannual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)paid time off varying by role and tenure in addition to 10 company holidaysup to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)one-time furniture and equipment allowance for employees working from homeup to $225 in Amazon gift cards for participating in various well-being activities. for a complete list see our External Total Rewards page.We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.

Behavioral Health Care Management ClinicianRemote within OR, WA, UT, or ID. Candidates outside of these states will not be consideredAre you a Licensed Behavioral Health Professional that is passionate about making a difference? In this position, you would provide clinical care management to best meet the member's specific healthcare needs and to promote quality and cost-effective outcomes. You would oversees a collaborative process with the member and those involved in the member's care to assess, plan, implement, coordinate, monitor and evaluate care as needed.Responsibilities Responsible for essential activities of case management including assessment, planning, implementation, coordination, monitoring and evaluation. Assessment: collection of in-depth information about a member's situation and functioning to identify individual needs. Planning: identification of specific objectives, goals, and actions designed to meet the member's needs as identified in the assessment.Implementation: execution of the specific case management activities that will lead to accomplishing the goals set forth in the plan.Coordination: organization, securing, integrating and modifying resources. Monitoring: gathering sufficient information to determine the plan's effectiveness and the evaluation phase should determine the effectiveness of reaching the desired outcomes. Applies clinical expertise and judgment to ensure compliance with medical policy, medical necessity guidelines, and accepted standards of care. Utilizes evidence-based criteria that incorporates current and validated clinical research findings. Practices within the scope of their license.Consults with physician advisors to ensure clinically appropriate determinations.Serves as a resource to internal and external customers.Collaborates with other departments to resolve claims, quality of care, member or provider issues. Identifies problems or needed changes, recommends resolution, and participates in quality improvement efforts.Responds in writing or by phone to members, providers and regulatory organizations in a professional manner while protecting confidentiality of sensitive documents and issues.Provides consistent and accurate documentation.Plans, organizes and prioritizes assignments to comply with performance standards, corporate goals, and established timelines.Minimum Requirements Knowledge of health insurance industry trends, technology and contractual arrangements.General computer skills (including use of Microsoft Office, Outlook, internet search). Familiarity with health care documentation systems.Strong oral, written and interpersonal communication and customer service skills.Ability to interpret policies and procedures, make decisions, and communicate complex topics effectively.Strong organization and time management skills with the ability to manage workload independently.Ability to think critically and make decision within individual role and responsibility.Normally to be proficient in the competencies listed aboveBehavioral Health Clinical Manager would have a Master's Degree in Behavioral Health Discipline and 3 years of case management, utilization management, disease management, or behavioral health case management experience or equivalent combination of education and experience. Required Licenses, Certifications, Registration, Etc.Must have 3 years direct behavioral Health clinical experience as an independently licensed Master's level Behavioral Health Clinician (no associate or interns) in one of the areas of Psychology, Counselling, Social Work, or Marriage and Family Therapy (LICSW, LCSW, LMHC, LPC and LMFT). Clinical License must be unrestricted and current in state of residence.#LI-RemoteThe expected hiring range for a Behavioral Health Care Management Clinician is $42.00 - $44.00 an hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 10%. The current full salary range for this role is $33.80 - $55.00 an hour. Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:medical, dental, and vision coverage for employees and their eligible family membersannual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)paid time off varying by role and tenure in addition to 10 company holidaysup to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)one-time furniture and equipment allowance for employees working from homeup to $225 in Amazon gift cards for participating in various well-being activities. for a complete list see our External Total Rewards page.We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.

Pharmacy Services TechnicianLooking for candidates within Idaho, but the right candidate will be eligible for a remote role within our 4-state footprint (WA, ID, OR, and UT).Primary Job PurposeThe Pharmacy Services Technician is a corporate-wide technical support resource for pharmacy benefit, reimbursement, and other drug use issues which do not require clinical judgment. This function assists the Clinical Pharmacy Consultants and Pharmacy Services staff with formulary-related operations and other operational processes which require knowledge and experience with pharmaceuticals.Normally to be proficient in the competencies listed below:Pharmacy Services Technician would have a high school diploma or related certificate and five years of experience as a pharmacy services technician in a retail, hospital, or other licensed pharmacy setting or equivalent combination of education and experience. Pharm tech certificate may be substituted for two years of experience.Responsibilities:Performs all duties as described in this document unless doing so would require clinical judgement. In any situation in which clinical judgment is necessary, the Pharmacy Services Technician will seek assistance from appropriate medical personnel. Appropriate medical personnel will be available for support during normal business hours.Responds to non-clinical pharmacy issues from providers, pharmacy services staff, case managers, preauthorization nurses, ENCC personnel, and government programs personnel and customer service. These pharmacy issues include formulary drug coverage, appeal and reconsideration claim status, and pricing for drug claims.Completes daily formulary operational processes, including tracking, processing, and obtaining appropriate documentation for pharmacy medical exception requests, prior authorization requests, reconsiderations, and appeals. Prepares reconsideration requests for Clinical Pharmacy Consultant review by obtaining and organizing appropriate documentation, including, but not limited to medical chart notes/reports and medication profiles. Communicates (orally and by written documentation) information and determinations to providers and members as necessary.Obtains and organizes drug utilization data, including patient specific and population-based data, in a manner which facilitates clinical review and decisions by Clinical Pharmacist Consultants. Organizing data includes but is not limited to sorting drugs into appropriate therapeutic and generic categories.Assists with auditing and investigations of medication-related claims, cases, and providers to identify misuse of medications, misuse of (Regence HMO Oregon) resources, substance abuse, and erroneous and fraudulent billing practices. Investigates and organizes workflow for claims referred to Pharmacy Services for review and allowable determination (misc. J codes, providers on review, reconsiderations).Supports wellness and disease state management programs for Pharmacy Service and corporately which contribute to NCQA accreditation and ongoing quality improvement.Contributes to and supports the corporation's quality initiatives through process improvement teams and by encouraging team and individual contributions toward the corporation's quality improvement efforts.Minimum Requirements:Knowledge of medical terminology, health care coding systems such as ICD-10, CPT and HCPCS and HIPAA regulations.Knowledge of pharmaceutical products, including orals, injectables, infusion products, and chemotherapy.Knowledge of general office practices and procedures.Demonstrated knowledge of grammar and techniques of business practice.Ability to interact effectively with a variety of health care professionals, including physicians, nurses, pharmacists, and billing staff both internally and externally.Demonstrate maturity, tact, diplomacy, and persuasiveness.Demonstrated ability to perform pharmaceutical pricing calculations.Ability to type 30 words per minute, 60 wpm preferred.Demonstrated ability to operate a variety of standard business machines including calculators, copiers, and faxes.Basic computer programs skills (Word, Excel, etc.).Ability to organize, plan, and prioritize daily workflow and projects within time constraints.Experience with health insurance and/or prescription benefits preferred.Work Environment:Work primarily performed in an in-home environment.May be required to work overtime.The base pay annual salary range for this job is $18.80 - $34.10/hour,depending on candidate's geographic location and experience.The annual incentive payment target for this position is 5%.Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:medical, dental, and vision coverage for employees and their eligible family membersannual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)paid time off varying by role and tenure in addition to 10 company holidaysup to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)one-time furniture and equipment allowance for employees working from homeup to $225 in Amazon gift cards for participating in various well-being activities. for a complete list see our External Total Rewards page.We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.

Provides care coordination to members with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including multiple, clinical, social and community resources.•Conducts in depth health risk assessment and/or comprehensive needs assessment which includes, but is not limited topsycho-social, physical, medical, behavioral, environmental, and financial parameters.•Communicates and develops the care plan and serves as point of contact to ensure services are rendered appropriately, (i.e.during transition to home care, back up plans, community based services).• Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes.•Develops, documents and implements plan which provides appropriate resources to address social, physical, mental,emotional, spiritual and supportive needs.• Acts as an advocate for member`s care needs by identifying and addressing gaps in care.• Performs ongoing monitoring of the plan of care to evaluate effectiveness.• Measures the effectiveness of interventions as identified in the members care plan.• Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes.• Collects clinical path variance data that indicates potential areas for improvement of case and services provided.• Works with members and the interdisciplinary care plan team to adjust plan of care, when necessary.•Educates providers, supporting staff, members and families regarding care coordination role and health strategies with afocus on member-focused approach to care.• Facilitates a team approach to the coordination and cost effective delivery to quality care and services.•Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effectivedelivery of quality care and services across the continuum.•Collaborates with the interdisciplinary care plan team which may include member, caregivers, member`s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services. Utilizes licensed care coordination staff as appropriate for complex cases.• Provides assistance to members with questions and concerns regarding care, providers or delivery system.• Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources.• Generates reports in accordance with care coordination goal.Coordinates care of individual clients with application to identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes. Duties are typically performed during face-to-face home visits. Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction. Assists with orientation and mentoring of new team members as appropriate.Provides care coordination to members with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including multiple, clinical, social and community resources.Conducts in depth health risk assessment and/or comprehensive needs assessment which includes, but is not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters.Communicates and develops the care plan and serves as point of contact to ensure services are rendered appropriately, (i.e. during transition to home care, back up plans, community based services).Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes.Develops, documents and implements plan which provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs.Acts as an advocate for member`s care needs by identifying and addressing gaps in care.Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the members care plan.Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes. Collects clinical path variance data that indicates potential areas for improvement of case and services provided. Works with members and the interdisciplinary care plan team to adjust plan of care, when necessary.Educates providers, supporting staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care.Facilitates a team approach to the coordination and cost effective delivery to quality care and services. Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum.Collaborates with the interdisciplinary care plan team which may include member, caregivers, member`s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services. Utilizes licensed care coordination staff as appropriate for complex cases.Provides assistance to members with questions and concerns regarding care, providers or delivery system.Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources.Generates reports in accordance with care coordination goal.Other Job RequirementsResponsibilities3-5 years experience in Social Work, Nursing, or Healthcare-related field, or relevant experience in lieu of degree., Experience in utilization management, quality assurance, home or facility care, community health, long term care or occupational health required.Experience in analyzing trends based on decision support systems.Business management skills to include, but not limited to, cost/benefit analysis, negotiation, and cost containment.Knowledge of referral coordination to community and private/public resources.Requires detailed knowledge of cost-effective coordination of care in terms of what and how work is to be done as well as why it is done, this level include interpretation of data.Ability to make decisions that require significant analysis and investigation with solutions requiring significant original thinking.Ability to determine appropriate courses of action in more complex situations that may not be addressed by existing policies or protocols.Decisions include such matters as changing in staffing levels, order in which work is done, and application of established procedures.Ability to maintain complete and accurate enrollee records.Effective verbal and written communication skills. Ability to work well with clinicians, hospital officials and service agency contacts.General Job InformationTitleCare Coordinator (Bilingual/ Spanish)Grade22Work Experience - RequiredClinical, QualityWork Experience - PreferredEducation - RequiredGED, High SchoolEducation - PreferredAssociate, Bachelor'sLicense and Certifications - RequiredDL - Driver License, Valid In State - OtherLicense and Certifications - PreferredCCM - Certified Case Manager - Care Mgmt, LCSW - Licensed Clinical Social Worker - Care Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtSalary RangeSalary Minimum:$50,225Salary Maximum:$75,335This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

Looking for a way to make an impact and help people?Join PacificSource and help our members access quality, affordable care!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.Manage the daily operations, including oversight/supervision of the Care Management Team which may include the following: Health Services Representatives (HSR) Member Support Specialists (MSS) and Nurse Case Managers (NCM) and Behavioral Health Clinicians involved in care coordination and case management functions. Key participant in Health Services (HS) strategy, program development and implementation. Integrally involved in, and accountable for, the success of the PacificSource Care Management program development and performance internal measures as well as those established by regulatory entities.Essential Responsibilities:Work closely with the HS Director and other HS Managers to facilitate the development and implementation of new programs and processes to support ongoing success of department goals and initiatives, including but not limited to; ongoing activities related to physical and behavioral health integration and the development of a cohesive team approach to care management.Foster effective teamwork and performance. Manage change and encourage innovation. Build collaborative relationships, encourage involvement and initiative and develop goal orientation in others.Take a leadership role in initiation and implementation of departmental process/performance improvement activities Responsible for process improvement and working with other departments to improve interdepartmental processes. Utilize LEAN methodologies for continuous improvement. Utilize visual boards and frequent huddles to monitor key performance indicators and identify improvement opportunities.Serve as back-up for the Director of Care Management and Utilization Management Manager, as needed.Work collaboratively with the UM Director and Manager Team to develop, implement, and oversee the utilization management process to include; coordination of prior authorization needs for members engaged with care management, as well as the inpatient concurrent review process to ensure medical appropriateness, care coordination needs, and discharge planning for PacificSource patients who have been hospitalized.Develop and oversee the care management process to ensure care coordination and case management needs of PacificSource's are being met and their outcomes are being improved.Ensures consistent workflow and a comprehensive database of patients enrolled in care management and care coordination programs that allows for tracking of case loads, case management program success or failure, and patient and population outcomes.Ensure nurse case managers are providing timely notification of large cases to finance, underwriting, stop loss and other company leaders, as necessary.Serve as key driver and participant to ensure PacificSource care management programs are coordinated with the case management and care coordination functions of our provider and community partners.Responsible for oversight, management, development, implementation, and communication of HS case management and care coordination programs that coordinate and augment community partner programs.Oversee and monitor processes to ensure the protection of personal health information.Facilitate the provision of exceptional customer service to members, providers, employers, agents, and other external and internal customers. Ensure that the delivery of services meet acceptable standards and company and customer expectations.Monitor, evaluate, and report performance relating to volumes, quality, outcomes, accuracy, customer service, and other performance objectives.Serve as a liaison with all PacificSource departments to coordinate optimal provision of service and information.Serve as a resource and participate in development of policies, procedures, and operations.Collaborate and coordinate Health Services department staff between regional offices. At regional offices, represent Health Services by serving on management teams and support marketing and development initiatives towards achievement of PacificSource Health Plans goals specific to the region.Attend continuing education opportunities relevant to case management and care coordination to ensure that PacificSource care management programs maintain current best practices and implement innovative models of care.Maintain frequent and consistent department meetings and one-on-one meetings with individual contributors.Establish and monitor progress towards goals for care management programs, including case loads, outcomes, case timeliness, quality of interventions, training and physician outreach efforts.Encourage and support team members in their pursuit of case management and care coordination certifications.Responsible for hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees. Provide feedback to direct reports, including regular one-on-ones and performance evaluations.Develop annual department budgets. Monitor spending versus the planned budgeted throughout the year and take corrective action where needed.Coordinate business activities by maintaining collaborative partnerships with key departments.Actively participate as a key team member in Manager/Supervisor meetings and HS Management meetings.Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.Ensures ongoing monitoring and adherence to applicable state and federal regulatory and associated compliance requirements.Supporting Responsibilities:Meet department and company performance and attendance expectations.Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.Perform other duties as assigned.SUCCESS PROFILEWork Experience: 5 years clinical experience required. A minimum of 3 years direct health plan experience in case management, utilization management, or disease management, or equivalent preferred. Prior supervisory or management experience required.Education, Certificates, Licenses: Registered Nurse or Licensed Clinical Social Worker or other licensed healthcare or behavioral health care clinician, Oregon licensure required. 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: Thorough knowledge and understanding of medical and behavioral health procedures, diagnoses, and treatment modalities, procedure codes, including ICD-9 & 10, DSM-IV & V, CPT codes, health insurance and State of Oregon mandated benefits. Knowledge of community services, providers, vendors and facilities available to assist members. Strong knowledge of health insurance; including managed care products as well as state mandated benefits. Ability to develop, review and evaluate utilization and care management reports. Experience in adult education preferred. Proficient in the use and implementation of the following tools and concepts across all teams within scope and accountability: Training, Coaching, Strategy Deployment, Daily Operations, Visual Management, Operational Improvement & Team Building/Development.Competencies:Building TrustBuilding a Successful TeamAligning Performance for SuccessBuilding PartnershipsCustomer FocusContinuous ImprovementDecision MakingFacilitating ChangeLeveraging DiversityDriving for ResultsEnvironment: Work inside in a general office setting with ergonomically configured equipment, as needed. Travel is required approximately 20% of the time.Skills:Accountable leadership, Collaboration, Communication, Data-driven & Analytical, Delegation, Listening (active), Situational Leadership, Strategic ThinkingOur ValuesWe live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:We are committed to doing the right thing.We are one team working toward a common goal.We are each responsible for customer service.We practice open communication at all levels of the company to foster individual, team and company growth.We actively participate in efforts to improve our many communities-internally and externally.We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.We encourage creativity, innovation, and the pursuit of excellence.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.

This is a remote position that requires up to 70% regional travel. Candidates must reside in an NLC state - https://www.nursecompact.com/. Hourly Range is determined by Level (commensurate with experience) as follows: Level II  - $28.79 - $30.31 (1-3 years of exp.)Level III - $34.23 - $36.04 (3-5 years of exp.)Level IV - $39.72 - $41.82 (5+ years of exp.) Including eligibility for quarterly bonuses. If you are passionate about patient care and love to travel all while maintaining a healthy work/life balance...You may want to explore this opportunity. Leidos QTC Health Services is looking to expand the Travel Team with experienced LPN LVNs in the following states - ID, UT, CO, KS, MO, AR, MS, NC, SC, IN, MA. Travel up to 70% regionally (within your designated Region) to support Mobile Clinical Operations (MCO) and more importantly.....to support our veterans! Ideal candidate will reside in a state that is in the nursing compact and have an active/valid Nurse Licensure Compact (NLC). We are a government contractor and subsidiary of Leidos, a FORTUNE 500 science and technology leader. We are the largest provider of disability (pension) and occupational health examination services. A few of our clients include U.S. Department of Veteran Affairs (VA), Department of Justice, U.S. Department of Labor and several others. With over 90 clinics nationwide, we’ve been serving communities for over 40 years. We offer a competitive compensation package including quarterly bonuses and annual merit review increases, comprehensive health benefits, substantial opportunity for growth, tuition reimbursement and career development. We offer meaningful and engaging careers to support you and your career goals, all while nurturing a healthy work-life balance, and we are proud to provide an employment package that attracts, develops and retains the best talent: Competitive compensation and quarterly bonuses Tuition reimbursement A 50% company match of your pre- and post-tax contributions up to 6% of your salary, including immediate vesting of company contributions Generous paid time off (minimum of 14 days/year), as well as 9 paid holidays Access to flexible benefits, including health and wellness programs, long and short term disability, an employee assistance program, employee referral bonuses, credit union access and flexible spending accounts An inclusive and ethical work place In this rewarding role you will:                                                                                                                                                                                                                                                            Provide assistance to attending clinical provider including: assisting patients, taking medical histories, injections of medications and immunizations, etc. Accurately receive and carry out clinical staff/provider orders. Perform standard diagnostic procedures including but not limited to: EKGs, venipuncture, and preparation and or running of lab specimens for laboratory courier, PFTs, arterial flow Doppler studies, and other clinical diagnostic studies assigned  Perform housekeeping functions such as: changing exam room table paper, upkeep of cleanliness of the entire office  Chaperone during examinations as required or requested Be responsible for front office duties such as: answering telephones, preparing schedules and confirming appointments, data entry, filing and inventory  Verify information through dialogue with clinical provider on all orders/instructions given.  Assist in the reconciliation and identification of medications for upload and possible refill in the EMR application Work with providers and operational teams to ensure reports are submitted timely and accurately, may assist in preparation and delivery of reports Be responsible for administrative duties on-site including completion of expense reports in a timely manner following company policy You must have: A High School Diploma, or equivalent GED.  Bachelor’s Degree preferred. A minimum of 1+ years of hands on clinical experience in Primary Care, Family Care, Internal Medicine, Urgent Care or ER. Current use and proficiency of/in Manual Vitals, EKGs, Blood Draws, and Venipuncture.  A clean and clear LPN/LVN license. An Advanced Cardiovascular Life Support (ACLS) certification required (those willing to obtain prior to hire may apply). A Nurse Licensure Compact (NLC) to operate across the U.S. (prior to hire). A valid U.S. Driver’s License and ability/willingness to drive between work locations. Residecy in a state that is in the nursing compact, and reside within 50 miles (or less) of a major US airport. The ability to successfully pass National Agency Check with Inquiries (NACI) background investigation. *Employment as a Travel LPN LVN will include successful completion of a 90-day probationary period during which you will be given objectives to achieve. This timeframe lets you assess your readiness for the position as well as allows Leidos Health QTC Services to determine your ability to successfully perform the job. You will be provided objectives, documentation, training and performance feedback during the 90-day probationary period as part of your assimilation to the role. After successfully completing the 90-day probationary period, you will be considered a permanent employee.   Pay and Benefits The Leidos QTC Health Services pay range for this job level is a general guideline only and not a guarantee of compensation or salary. Additional factors considered in extending an offer include (but are not limited to): geographic location, responsibilities of the job, education, experience, knowledge, skills, and abilities, as well as internal equity, alignment with market data, applicable bargaining agreement (if any), or other law. Leidos QTC Health Services. is a VEVRAA Federal contractor and an Equal Opportunity Employer. The company has an ongoing commitment to affirmative action and the creation of a workplace free of discrimination, harassment and retaliation. The company recruits, hires, trains, and promotes individuals in all job titles without regard to race, color, creed, religion, ancestry, national origin, age, sex, pregnancy, sexual orientation, gender identity, genetic information, people with disabilities protected under law, and protected veteran status.Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c) LPN/LVN

Faith Technologies, a division of Faith Technologies Incorporated (FTI), is an energy expert and national leader in electrical planning, engineering, design and installation. As a comprehensive authority in the field of electrical and energy services, Faith leads industry change through a dedicated investment in technology, strategic project consulting and process engineering that drives productivity, value, and above all, safety. Through innovative practices, Faith drives trends in growth and development with continual investment in their merit-based employees' skill, leadership and career development.Specialty Systems Technicians are responsible for a wide range of systems installations, troubleshooting and maintenance through well-versed knowledge of applicable codes and standards. Our job site professionals thrive under self-directed management to complete projects on time and safely. All job site employees participate and drive safety initiatives such as tool-box talks and operational risk management meetings to proactively identify safe practices for our people. Our crews rely on teamwork to drive results through strategic use of partnerships and planning. We pride ourselves on a "Ground up Growth" mentality that puts you in the spotlight. Becoming a member of the Faith Technologies team means you've officially put yourself in the driver's seat of your career. Through our career development and continued education programs, you'll have options to position yourself for success. Faith is a "Merit to the Core" organization, and we pride ourselves on our ability to reward and recognize top performers. MINIMUM REQUIREMENTS Education: Completion of Electronic Systems Technician (EST) Apprenticeship Program (if applicable) Holds BICSI or NICET CertificationRequired: The ability to effectively communicate in the English language. This includes the ability to understand the spoken and written word as well as speak in English. Travel: 5-10%Work Schedule: This position works between the hours of 6 am to 6 pm, Monday through Friday. May vary based on customer demands and can include, but is not limited to: nights, weekends, and holidays. KEY RESPONSIBILITIES Provides installation and troubleshooting for a wide range of systems including voice and data, fiber optics, fire alarm, security, access control, closed circuit television, nurse call, etc. Analyzes blueprints effectively for job site knowledge. Evaluates upcoming tasks and anticipates equipment, procedures and training needs. Enforces a safe job site and maintain compliance with company safety, OSHA and customer-specific safety standards. Demonstrates excellent customer relations though utilization of effective problem-solving techniques. Provides direction, training, and mentorship to Helpers/Apprentices. The job description and responsibilities described are intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended as a comprehensive list of all functions, responsibilities, skills or abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. SURGE your career forward!Employees at FTI grow faster because they are a part of a nationally leading team of electrical planners, engineers, designers, electricians, and business professionals. Your Personal Growth : Build your career path by taking advantage of our industry leading training and leadership development programs. Leverage Technology : Our virtual design and build programs that offer the latest in robotic total stations, 3D scanning, virtual and augmented reality and drone surveillance and assessment. Uncompromised Safety : When we see others in our space averaging 2.7 safety rating and ours average .42, you know that we value you and your safety above all else.We offer competitive, merit-based wages; career path development and flexible and a robust benefits package that boasts everything from paid training, tuition reimbursement and a top-notch wellness program.We pride ourselves on a "Ground up Growth" mentality that puts you in the spotlight. Becoming a member of the FTI team means you've officially put yourself in the driver's seat of your career. Through our career development and continued education programs, you'll have options to position yourself for success.FTI is a "Merit to the Core" organization, and we pride ourselves on our ability to reward and recognize top performers.BENEFITS ARE THE GAME CHANGERFTI enriches the lives of its employees through industry-leading total rewards. Our compensation, benefits, time off, and wellness programs are designed to reward individual results that create team success, improve financial security for our employees and their families, and encourage healthy lifestyles. As an eligible employee*, your programs include:Medical, Dental, Vision, and Prescription Drug InsuranceCompany-Paid Life and Disability InsuranceFlexible Spending and Health Savings AccountsAward-Winning Wellness Program and Incentives401(k) Retirement & 401(a) Profit Sharing PlansPaid Time OffPerformance Incentives/BonusesTuition ReimbursementAnd so much more!*Regular/Full-Time Employees are eligible for FTI benefit programs.We stand strong in our values as we work to Create World-Class Opportunities to Succeed through:Uncompromised focus on keeping people SAFE.Building TRUST in everything we do.REDEFINING what's possible.Rewarding individual results that create TEAM SUCCESS.If you're ready to learn more about growing your career with us, apply today!Faith Technologies, Inc. (FTI) is an Affirmative Action Employer/Equal Opportunity Employer. FTI will not discriminate against applicants based on race, color, religion, national origin, sex (including pregnancy and gender identity), sexual orientation, genetic information, or because they are an individual with a disability or a person 40 years old or older. Faith Technologies, Inc. will take affirmative action to provide equal opportunity in apprenticeship and will operate the apprenticeship program as required under Title 29 of the Code of Federal Regulations, part 30.

Care Management Nurse - Hybrid ID - Independent Doctors of Idaho (IDID)Primary Job Purpose The Care Management Nurse provides clinical care management (such as case management, disease management, and/or care coordination) to best meet the member's specific healthcare needs and to promote quality and cost-effective outcomes. Oversees a collaborative process with the member and those involved in the member's care to assess, plan, implement, coordinate, monitor and evaluate care as needed. General Functions and Outcomes Responsible for essential activities of case management including assessment, planning, implementation, coordination, monitoring and evaluation. Assessment: collection of in-depth information about a member's situation and functioning to identify individual needs. Planning: identification of specific objectives, goals, and actions designed to meet the member's needs as identified in the assessment.Implementation: execution of the specific case management activities that will lead to accomplishing the goals set forth in the plan.Coordination: organization, securing, integrating and modifying resources. Monitoring: gathering sufficient information to determine the plan's effectiveness and the evaluation phase should determine the effectiveness of reaching the desired outcomes. Applies clinical expertise and judgment to ensure compliance with medical policy, medical necessity guidelines, and accepted standards of care. Utilizes evidence-based criteria that incorporates current and validated clinical research findings. Practices within the scope of their license.Consults with physician advisors to ensure clinically appropriate determinations.Serves as a resource to internal and external customers.Collaborates with other departments to resolve claims, quality of care, member or provider issues. Identifies problems or needed changes, recommends resolution, and participates in quality improvement efforts.Responds in writing or by phone to members, providers and regulatory organizations in a professional manner while protecting confidentiality of sensitive documents and issues.Provides consistent and accurate documentation.Plans, organizes and prioritizes assignments to comply with performance standards, corporate goals, and established timelines.Minimum Requirements Knowledge of health insurance industry trends, technology and contractual arrangements.General computer skills (including use of Microsoft Office, Outlook, internet search). Familiarity with health care documentation systems.Strong oral, written and interpersonal communication and customer service skills.Ability to interpret policies and procedures, make decisions, and communicate complex topics effectively.Strong organization and time management skills with the ability to manage workload independently.Ability to think critically and make decision within individual role and responsibility.Normally to be proficient in the competencies listed above Care Management Nurse would have a/an Associate or Bachelor's Degree in Nursing or related field and 3 years of case management, utilization management, disease management, or behavioral health case management experience or equivalent combination of education and experience. Required Licenses, Certifications, Registration, Etc. Must have licensure or certification, in a state or territory of the United States, in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice for the discipline (e.g. medical vs. behavioral health) and at least 3 years (or full time equivalent) of direct clinical careMust have at least one of the following: Certification as a case manager from the URAC-approved list of certifications; or Bachelor's degree (or higher) in a health or human services-related field (psychiatric RN or Master's degree in Behavioral Health preferred for behavioral health care management); or Registered nurse (RN) license (must have a current unrestricted RN license for medical care management)Work Environment Duties performed at home and in Independent Doctors of Idaho - IDIDThe expected hiring range for a Care Management Nurse is $36.00 - $48.60 an hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 10%. The current full salary range for this role is $33.80 - $55.00 an hour. Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:medical, dental, and vision coverage for employees and their eligible family membersannual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)paid time off varying by role and tenure in addition to 10 company holidaysup to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)one-time furniture and equipment allowance for employees working from homeup to $225 in Amazon gift cards for participating in various well-being activities. for a complete list see our External Total Rewards page.We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.

Looking for a way to make an impact and help people?Join PacificSource and help our members access quality, affordable care!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.This position will take lead role the development and implementation of multi-year Care Management (CM) transformation and improvement plan in service to the out Population Health vision. This position will work closely with the CM Director as well as internal and external stakeholders (including, but not limited to, key internal teams such as Population Health, Quality Improvement, Provider Network, Compliance and Medicare/Medicaid Administration, along with providers and community partners) to develop and lead CM initiatives in accordance with CMS, OHA and NCQA requirements. This includes pursuing goals to identify evidence based best practice and elevate/scale/operationalize a standardized integrated (physical health, behavioral health, oral health) CM approach across lines of business and regions. This role requires strong and effective relationships to lead multi-stakeholder strategic planning efforts, as well as strong execution skills in order to effectuate internal and/or external work plans.Essential Responsibilities:Serve as a Care Management subject matter expert and effectively share expertise with internal stakeholders including, but not limited to Compliance, Quality Improvement, Population Health, and Provider Network.Maintain knowledge and expertise in CMS and OHA regulatory requirements. Act as primary audit contact for CMS and OHA.Represent the company across regions as subject matter expert and Care Management compliance and regulatory leader across Government Lines of Business's (LOB's).Serve as a key subject matter expert for integrating additional regulatory/compliance requirements by identifying strategies, leading teams to build necessary work flows and ensuring required reporting capabilities are met.Accountable for ensuring compliance to federal and state regulatory requirements related to Care Management across line of business, including activities performed within PacificSource and in conjunction with critical community providers.Accountable for strategic development, implementation and oversight of a multi-year Government transformation and improvement strategy by leading efforts in collaboration with internal and external stakeholders such Population Health, Quality Improvement, Behavioral Health, Compliance and Provider Network along with providers and community partners.Collaborate and support additional population health, clinical quality outcomes and future business opportunities to effectuate Care Management transformation strategies including new and emerging opportunities for expanded programming and services.In conjunction with other subject matter experts, develop and deploy components of workforce plans, health equity plans, training plans, Transformation and Quality Strategy initiatives, and quality improvement initiatives.Demonstrates strong analytical skills and ability to successfully collaborate with analytics to establish process, outcome and value metrics for clinics in integrated system of care in primary and specialty behavioral health.Demonstrate ability to successfully navigate in a matrixed organization, a history of executing in a fast-paced environment, and ability to remain accountable for deliverables while working in partnership with others throughout the organization.Analyze and interpret data in collaboration with other departments to identify population health cost savings and care improvement opportunities across the continuum of care and make recommendations for innovative initiatives and integrated health strategies with provider partners.Actively participate in various internal and external committees in order to provide care management expertise, disseminate information, and promote BH transformation and improvement strategies.Coordinate with other departments to understand and deploy needed CM clinical strategies as dictated by evidence-based criteria, legislation and parity needed.Demonstrate strong communication skills (verbal and written) to ensure effective relationships and follow through.Utilize Lean methodologies to identify process improvement and cultivate a culture of continuous improvement.Supporting Responsibilities:Work with department leadership in responding to inquiries or complaints to the Insurance Commission, preparing reports for other review functions, and addressing grievances and appeals.Advise the Company regarding the appropriateness of reimbursement for services, considering diagnosis, and contract provisions.Coordinate business activities by maintaining collaborative partnerships with key departments.Meet department and company performance and attendance expectations.Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.Perform other duties as assigned.Work Experience: A minimum of six years clinical care/case management experience with varied health care exposure and experience. Experience within clinics and community-based settings preferred. Demonstrated knowledge and experience with program development. Demonstrated execution of complicated initiatives in a matrixed environment. Experience working within the Coordinated Care Organization environment preferred.Education, Certificates, Licenses: Behavioral health professional with extensive experience and/or credentials, or a registered nurse with current unrestricted Oregon license and psychiatric experience is required. Bachelor degree in health services administration, social work, nursing or related field required, Master's preferredKnowledge: Thorough knowledge and understanding of medical and behavioral procedures, diagnoses, treatment modalities, procedure codes, including ICD-9 & 10, DSM-IV & V, and CPT Codes, health insurance and mandated benefits (including those provided by a wide array of community partners) within Oregon and the Pacific Northwest. Thorough knowledge of CMS and OHA regulatory requirements. Knowledge of community services, providers, vendors and facilities available to assist members across geographic regions. Ability to use computerized systems for data and document recording and retrieval. Maintain current clinical knowledge base. Proficient in the use and implementation of the following tools and concepts across all teams within scope of accountability: Strategy Deployment, Daily Operations, Visual Management, Operational Improvement, auditing.Competencies:Building TrustBuilding a Successful TeamAligning Performance for SuccessBuilding PartnershipsCustomer FocusContinuous ImprovementDecision MakingFacilitating ChangeLeveraging DiversityDriving for ResultsAutonomous accountable workEnvironment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 15% of the time within Oregon to local CCOs and associated communities.Skills:Accountability, Collaboration, Communication (written/verbal), Flexibility, Group Problem Solving, Listening (active), Organizational skills/Planning and Organization, TeamworkOur ValuesWe live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:We are committed to doing the right thing.We are one team working toward a common goal.We are each responsible for customer service.We practice open communication at all levels of the company to foster individual, team and company growth.We actively participate in efforts to improve our many communities-internally and externally.We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.We encourage creativity, innovation, and the pursuit of excellence.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.