Travel Nurse Salary in Portland, ME

Location: Portland, ORDescription: Our client is currently seeking Nurse Practitioners for PRN Home Assessments all over the USA. These roles are doing home assessments on a PRN basis. This is direct hire with the client. You will be traveling in the community performing assessments and assigned a territory This job will have the following responsibilities:During a visit that can last up to one hour, review and observe a member's current health, medical history, medication adherence, social environment and other risks. This provides unmatched insight into a member's overall health and well-being that can be difficult to capture during routine office visits. The Health Assessment helps to improve quality of care and allows us to potentially close multiple care gaps with a single visit. Hours: Days, Evening, Nights, weekend. Flexible Scheduling Qualifications & Requirements: Master's Degree required OR commensurate experience and satisfactory completion of NP licensure. Current NP licensure in state of practice to include prescription authority or the ability to obtain prescriptive authority. • Board certified by the AANP, ANCCCurrent BLS, ACLS or CPR certification. Have a Minimum of 1 year experience as a Nurse Practitioner Have strong computer skills and familiarity with Employee health/medical record software. •Possess excellent verbal and written communication skills with patient, clients and colleagues. •Be comfortable and flexible with frequent change. Travel Requirements: • Have the ability to travel, a valid state driver license and able to drive a car, proof of adequate automobile insurance coverage for the state of residence. Travel may be required Contact: [email protected] job and many more are available through The Judge Group. Find us on the web at www.judge.com

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.

Legacy HealthCase Manager - Resource TeamEqual Opportunity Employer/Vet/DisabledUS-OR-PORTLANDJob ID: 24-37512Type: Regular Full-TimeMultiple Locations - Portland MetroOverview You embody the legacy mission of making life better for others. Through your expertise and compassion, you guide the care management team, ensuring the highest level of care for acute and chronic patients. Your vision creates an ideal atmosphere in which care team members thrive and patients receive the respect and attention they deserve.The primary function of this job is to be available and flexible to float to various sites throughout Legacy Health System and provide RN Case Management services. Coordinates and facilitates interdisciplinary provision of comprehensive, patient-centered, quality health care throughout the continuum for patients with acute and chronic health conditions. Fosters achievement of optimal health care outcomes within accepted standards of care. Serves as an expert resource to the healthcare team regarding the continuum of care, efficient use of resources, Best Practice protocols, team-based care, quality indicators and improvements, and regulatory requirements. Ensures a smooth transition of care between multiple health care environments with planned handoffs. Partners with patients and families in identifying health care issues and barriers to self-care in order to set priorities and engage in appropriate interventions. Demonstrates cultural agility and employs health literacy guidelines to provide education regarding self-management strategies. Utilizes rapid quality improvement cycles to continuously monitor, evaluate, measure, and report progress of interventions and outcomes. Paces the case to assure appropriate and fiscally sound care coordination across the continuum. This position requires you travel to various Legacy Health locations. Click here to learn more about Legacy Health ResponsibilitiesThis position requires extensive knowledge of disease management to include diagnostics, treatment and prognosis, community resources and healthcare reimbursement. Minimum 2 years clinical nursing experience required. Relevant experience in one or more of the following healthcare areas preferred: Coordination of community resourcesCare management of diverse patient populationsAmbulatory Care Knowledge of levels of care throughout the health care continuum to include inpatient, emergency care, rehab, home health, hospice, long term acute care, SNF, ICF, ALF with an overall understanding of utilization management and resource management.Working knowledge of Care Management models across the continuum. Knowledge of six core components of case management: Psychosocial aspectsHealthcare reimbursementRehabilitationHealthcare management and deliveryPrinciples of practice i.e. CMS guidelines, Interqual criteriaCase Management concepts Excellent organizational skills.Health literate oral and written communication skills for effective interaction with all members of the patient’s health care team.Knowledge of transitional planning to and from all venues.Ability to determine and access appropriate community resources. Ability to engage patient/family in discussion of health care goals and decisions with attention to cultural and health literacy implications.Ability to adhere to and implement regulations in an effective manner. Must serve as a resource to all team members regarding regulatory issues.Keyboard skills and ability to navigate electronic systems applicable to job functions.QualificationsKnowledge of six core components of case management:Psychosocial aspectsHealthcare reimbursementRehabilitationHealthcare management and deliveryPrinciples of practice i.e. CMS guidelines, Interqual criteriaCase Management concepts General accountabilities and essential functions:Facilitates daily multidisciplinary care coordination meetings to clarify patient plan of care. Communicates with patients and their families concerning the progress of patient recovery goals and ongoing care needs. Organizes and/or participates in patient care conferences.Coordinates care and expected outcomes between patients/families and healthcare team including nurses, social workers, physicians, therapists, and community agencies and resources.Develops and maintains a collaborative working relationship with all team members. Follows evidence-based best practice. Serves as the clinical resource manager for patients with complex care needs. Provides consultations for patients who do not follow or have multiple variances from a pre-established clinical path. Assesses patient care priorities with patient and staff as part of the health care team and participates in determining outcomes of interventions.Collaborates with patient, family, and other health care professionals in the establishment of goals and implementation of patient plan of care. May provide home visits when necessary.Facilitates referrals, multidisciplinary review and planning for specific patients.Maintains currency in case management practice and principles specific to venue.Ensures transition plan reflects national guidelines and/or approved protocols/pathways.Maintains knowledge of professional standards of practice through participation in continuing education, community and professional activities, and committee membership.Assists patient care team to identify and coordinate appropriate level of care across the health care continuum.Focuses on promoting early intervention for complex patients and communicating a coordinated plan of care to prevent unnecessary complications and negative patient outcomes.Communicates with UM RN(s) and with insurance and community case managers, when appropriate, to discuss benefits and obtain authorization for alternative level of care. Assists health care team to incorporate the educational needs of patients and/or families concerning alterations in health and the disease process into the plan of care.Assists with patient and family education as appropriate and necessary.Collaborates with Legacy leadership to identify educational needs of staff.Participates in and/or leads committees and task forces.Participates in identifying needs and developing programs which facilitate attainment of organizational goals.Represents applicable clinical areas in the review and development of hospital and overall system policies, procedures, protocols, guidelines, and standards.Participates in Continuous Quality Improvement (CQI) activities.Participates in data collection, analysis and reporting of defined indicators to facilitate comprehensive evaluation of program impact.LEGACY’S VALUES IN ACTION:Follows guidelines set forth in Legacy’s Values in Action.PI239072037

Oregon Health & Science UniversityOregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or [email protected], Acute Care Float PoolUS-OR-PortlandJob ID: 2024-29453Type: Regular Full-Time# of Openings: 1Category: Nursing-RNPortland, OR (Marquam Hill)OverviewHiring Bonus up to $12,000 DOE and Relocation Package Available. Must begin work by July 1, 2024 to qualify to qualify. Earn what you are worth without traveling! Float Differential ($9/hr after training) plus Night Differential. $49.16-$78.18 per hour, based on education and experience With your acute care clinical expertise as a base (1 year of current nursing experience in adult acute care, adult intermediate care, and/or emergency department observation), we will teach you everything you need to know to float between various clinical specialty areas. Come be a part of our world-class healthcare team at OHSU! You will bring your nursing skills and expertise to our team of specialists working together to provide the best possible care. You will enjoy unmatched opportunities to learn and be inspired at Oregon’s only public academic health center. You will be part of our professional culture of safety, collaborative decision-making, innovation, life-long learning and teamwork. As an OHSU RN, your care delivery will be consistent with:The Oregon Nurse Practice ActThe ANA Scope and Standards of PracticeThe ANA Code of EthicsThe Onsomble Model of the Professional Role Benefits OHSU offers competitive, affordable benefits that include health care, income protection and more. See highlights below or learn more about OHSU benefits. Medical, dental and vision coverage at low or no cost to employeesAccess to retirement plansUp to 200 hours (equal to 25 full days) a year of paid time off96 hours of sick leave a year (prorated for part-time employees)Eight paid holidays a yearCommuter subsidiesTuition reimbursementAccess to group life insurance, disability insurance and other supplemental benefitsDiscounts just for OHSU members ResponsibilitiesMinimum requirements for all Nurses:Associate or Baccalaureate Degree in Nursing from a program accredited by Commission of Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN) or Commission for Nursing Education Accreditation (CNEA)BSN preferredAssociate Degree Nurses required to enroll in BSN program within 3 years of hire and complete within 5 years of hire. Internal ONA applicants: Associate's Degree in NursingCurrent unencumbered Oregon RN license by 1 week before the start date. Current BLS certification awarded by the American Heart Association (AHA) or Military Training Network branch of AHA by the start dateDepartment Specific Requirements:1 year of current nursing experience in adult acute care, adult intermediate care, and/or emergency department observationBLS must not expire during orientationTransition to Practice (TTP) Program Individualized Orientation tailored to applicant's needs: Our learning program is unique. You will receive a fellowship program tailored to your development needs for this specialty; which could be for 4 weeks and up to six months. Transition to hired shift may be delayed for a temporary reassignment due to individual development needs and skill mix of the employees on the unit or the hires shift at any given time.PI239489909

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.

Location: Portland, ORDescription: Our client is currently seeking a Critical Care Transport Registered Nurse-Contract Job Details: 13-week contract Variable Shifts 36 hours per week Start Date: 05/28/2024 Judge Group's Benefits Weekly Pay Medical/Dental/Vision insurance Customized Contract, Travel & Salary Packages built specifically for you Max allotted housing and meal stipends Paired with highly experienced contract recruiters that will guide you from start to finish Onboarding and compliance assistance Qualifications & Requirements: 3+ years recent experience with NICU and PICU transport American Heart Association BLS, ACLS, PALS, and NRP Active WASHINGOTN and OREGON state license Contact: [email protected] job and many more are available through The Judge Group. Find us on the web at www.judge.com

Location: Portland, ORSalary: Depends on ExperienceDescription: Our client is currently seeking a Nurse Practitioner to join their team!Scope Of Role:Location: Portland, OR ( Travel Benton, Linn, Marion, Polk, Yamhill, Clackamas, Washington, and Multnomah County)Hours: M- F 8am to 5pm (40 hours)Job Engagement: Contract 4-7 months**Covid-19 Vaccination Required**This Job Will Have The Following Responsibilities:Conduct comprehensive assessments, patient facing Effectively manage acute and chronic medical and behavioral conditionsEnsure accurate and complete documentation, including ICD 10 conditionsCommunicate and collaborate with the interdisciplinary care teamConduct advanced illness and advanced care planning conversations Provide patients and caregivers with counseling and educationQualifications & Requirements:NP: Graduate of an accredited Master of Science Nursing or Doctor of Nursing Practice programBoard certified through the American Academy of Nurse Practitioners or the American Nurses Credentialing Center, with certification in one of the following:Family Nurse Practitioner AdultNurse Practitioner GerontologyNurse Practitioner Adult-GerontologyAcute Care Nurse Practitioner1+ year of clinical experience in practice (long-term care setting preferred)Full COVID-19 vaccination is an essential requirement of this roleInterested? Send your updated resume to Emily Hartzell at [email protected] for consideration.Thank you, Contact: [email protected] job and many more are available through The Judge Group. Find us on the web at www.judge.com

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.