Practice Nurse Salary in Tacoma, WA

Seeking a Family Medicine Nurse Practitioner to join our care team, delivering evidence-based primarycare. The successful candidate will partner with the patient and the care teamto develop patient care plans, ensure comprehensive care in alignment with the medicalhome model, and provide clinical leadership.Compensation: $140,000.00 - $150,000.00Key Responsibilities:Provide evidence-based primary care to 10 to 15patients per day, focusing on prevention, delivering practical treatment forchronic and acute care needs, and providing disease and case managementservices.Partner with the patient and the care team, includingan onsite Whole Health Coach, to develop effective biopsychosocial patient careplans that meet the needs of each unique patient, respecting their diversebackgrounds.Ensure comprehensive care in alignment with the medicalhome model, including collection of comprehensive health history, performingappropriate physical examinations, conducting diagnostic testing, andprescribing medications – all with the convenience of onsite lab and pharmacy.Assess patient population needs and work with teammembers to drive participation in annual whole health evaluations, healthcoaching, and other health promotion activities.Provide clinical leadership, including participation inteam meetings, clear proactive communication, regular prioritization of keyefforts, process improvement, and actively supporting change management.Rotate with other providers in the region to ensurecoverage after-hours.Requirements:NP or PA Board Certification with primary care, familymedicine, or internal medicine background.Current, valid and unrestricted medical, ARNP or PAlicense and valid DEA number.Minimum 3-5 years of primary care experience.Minimum 2+ years with case management emphasizinghealth prevention and population health management.Experience working in EMR systems, NextGen preferred.Experience in coding and documentation, includingMedicare Advantage and HCC.Benefits:Competitive base pay.Premium medical, dental, vision coverage with healthsavings account (HSA) pre-tax savings option.Medical education coverage (2 weeks plus $2,500stipend).Matching 401(k) retirement program.Generous PTO and paid holidays.Employee Assistance Program (EAP).

We're in search of an experienced Family Medicine Nurse Practitioner for a locum position to bolster our primary care team. The ideal candidate will offer evidence-based primary care, craft personalized patient care plans, and uphold comprehensive care within the medical home framework while also providing clinical guidance.Key Responsibilities:Deliver evidence-based primary care to 10-15 patients daily, prioritizing both preventive measures and management of chronic and acute conditions.Work closely with patients and the healthcare team to devise tailored biopsychosocial care strategies.Ensure thorough care aligned with the medical home model, encompassing patient history gathering, physical examinations, diagnostics, and medication prescriptions, with the convenience of onsite lab and pharmacy services.Evaluate patient population needs and advocate for health assessments, coaching, and other wellness initiatives.Exhibit clinical leadership by fostering proactive communication, driving process enhancements, and offering support during transitions.Participate in rotating schedules with fellow providers to ensure round-the-clock coverage.Requirements:Board Certification as a Nurse Practitioner (NP) with a focus on primary care, family medicine, or internal medicine.Possession of a current, unrestricted medical license and DEA number.3-5 years of experience in primary care settings.At least 2 years of experience in case management, with an emphasis on preventive health measures and population health.Proficiency in EMR systems, preferably NextGen.Experience with coding and documentation, including Medicare Advantage and HCC protocols.

Are you looking to take back control of your work/life balance with a job that allows you to set your own schedule and work autonomously? Are you passionate about patient care? TeamHealth has the perfect opportunity for you. When you join TeamHealth, you will enjoy autonomy over your practice, an uncapped earning potential, and the opportunity to build a position that matches your ideal lifestyle and career goals.  TeamHealth is hiring for a nurse practitioner (NP) or physician assistant (PA) to work in a skilled nursing facilities Monday through Friday in the Tacoma, Washington, area. As an advanced practice provider in the skilled nursing facility setting your will experience:A Diverse Patient Population: Skilled nursing facilities provide clinicians with the opportunity to work with a diverse patient population, including individuals recovering from surgery, managing chronic conditions, or in need of rehabilitation. This variety can offer valuable experience in treating a range of medical conditions.An Interdisciplinary Collaboration: Working in a skilled nursing facility allows clinicians to collaborate with a multidisciplinary team, including nurses, therapists, social workers, and other healthcare professionals. This collaborative environment can enhance patient care by incorporating different perspectives and expertise.Long-Term Relationships: Clinicians in skilled nursing facilities have the opportunity to develop long-term relationships with patients and their families. Building rapport over time can lead to better continuity of care, improved patient outcomes, and a sense of fulfillment in providing ongoing support to individuals in need.Key Responsibilities:  Perform primary care in a post-acute setting for short term and long-term patientsManage chronic disease, diagnose illnesses and medical conditions, and implement plan of careOrder and interpret lab resultsPrescribe and monitor medicationsConsult with physicians and coordinate patient care with other healthcare practitionersEducate patients and their caregivers on coping skills to handle chronic and age-related conditionsBuild relationships with your patients, patients' family members, and facility staff to facilitate effective treatment deliveryPromote healthy lifestyle changesDesired Attributes:Critical thinking skillsExcellent communication skillsAbility to collaborate with the healthcare teamStrong work ethicAdaptability and flexibility to address the fluctuations that occur during the aging process and with chronic illness Empathy, compassion and ability to connect and engage with your senior patients or residentsRequirements:A minimum of 1 year experience as a nurse practitioner in a primary care setting requiredPost acute care experience a plus, but not requiredActive and unrestricted Washington NP license requiredActive and unrestricted Washington DEA requiredCompensation and Benefits:Our compensation is a productivity-based model (Fee for Service) that offers you control to maximize your income potential. Expected compensation is estimated salary range of $118,000/annually and $145,00/annually. This full-time role is benefit eligible.Full-time clinicians are eligible for an excellent comprehensive benefits package to include 401(k) plan, health, dental and vision insurance, long and short term disability, FSA, group term life insurance, Flex Time bank, and employee assistance program.If you are looking to take back control of your work/life balance, are passionate about patient care, apply today to be considered for this fantastic role!California Applicant Privacy Act:  

Mobile Anesthesiologist Wanted / Tacoma, WACurrently seeking a part time or full time Anesthesiologist for an opening with an all physician team that provides mobile anesthesia in the Tacoma, WA area.Average compensation is $2400 per day with a $1800 per day min.Mal practice insurance is covered by the practicePediatric dental anesthesia, some dental / oral surgery (teenagers, wisdom teeth). Health patients only. No call, weekends, evenings / nights. Early morning dental surgeries. Full mobile anesthesia team with trained assistants / nurses for patient recovery.This position is available immediately. Interested physicians please call Josh or text Josh at 407-221-3642 or simply reply to this post with your CV and contact info for more details.

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.

Leidos QTC Health Services is the nation’s largest provider of disability and occupational health examination services. We are passionate about our country’s veterans and service members, united as a team and inspired to make a difference. Leidos QTC Health Services is dedicated to provide quality, timeliness, and excellent customer service to these service members and you could be a part of that mission. We are seeking a Nurse Practitioner at our Tacoma, WA Clinic to help ensure our service members get the best care possible. You will play a vital role in the continued care of these men and women.  Your Role with Leidos QTC Health Services: As a Nurse Practitioner with Leidos QTC Health Services, you will conduct a variety of general medicine, occupational, and disability health examinations including, but not limited to:  Reviewing medical history and associated records Interpreting clinical data Completing written reports and generating independent medical opinions (IMO) The examinations may be completed in-person (in a clinic setting), in the examinee’s home, telephonically, at large event settings for the Reserve Health Readiness Program, or using telehealth platforms. You will be traveling (up to 30%) to provide physical examinations for veterans and service members in multiple locations throughout the country. All travel expenses are covered and a per diem will be received.  Pay Range: Salary: $110,000-$160,000 (based on years of experience and education) with a potential annual bonus up to 30%.  Leidos- QTC Health services employees also receive an annual merit increase as well as benefits being available upon first day of hire.  Work Schedule, Location, What to expect:   Mon-Fri 8:00am-5:00 pm with a 1-hour lunch from 12:00-1:00 pm. Tacoma, WA clinic  3 weeks onboarding / training 4-5 VA patients daily with 4 hours of admin time, 10-12 patients daily with other lines of business 30% national travel  We will pay for licensing in 12 state licenses and CME costs. Essential Duties and Responsibilities:  Physical examinations for the following lines of business: Department of Defense, Department of Justice, and Department of Labor. Occupational health exams to include pre- and post-employment and annual physicals. Generalist approach to multi-system disability evaluations to include evaluations of conditions specific to the military operational environment like Gulf War and Prisoner of War Most examinations are in-person evaluations, but some may be completed virtually or by medical record review only. Housebound physical examinations Completion of Veterans Benefits Administration Disability Benefit Questionnaires (DBQs) Provide primary medical evaluations to include, but not limited to, initial review of laboratory, pulmonary function and ECG studies Documentation of examinee records in appropriate systems. Collaboration with other professional and support staff as needed and communicate with internal and client team members in determining the most effective and evidence-based way forward on behalf of the examinee populations Competencies:  Demonstrates compassion, professionalism, and a commitment to providing excellent customer service and care to the claimants. From a primary care perspective, be able to fully assess examinee health status through physical examinations. Collaborative, proactive and informed standard of care-centric, decision-making skills. Analytical ability necessary to evaluate and determine medical opinions. Technically competent with computers/tablets to include proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and using Electronic Medical Records Knowledge of workplace health and safety concepts and OSHA regulations Must be able to receive a medical clearance that may consist of passing an N95 respirator fit test, pass a Tuberculosis/TB test and receive a Hepatitis A/B vaccine series or pass a Hepatitis A/B Titeror test.    Required Education and/or Experience: (includes certificate & licenses)  Unrestricted State medical licensure without limitations to perform full scope of authorized practice. National Licensing with ANCC or AANP Education and training in an US accredited, post-baccalaureate (Masters)  Minimum 3 years of post-graduate primary care experience Valid CPR or BLS certification Preferred Experience:   Specialty/sub-specialty clinical experience.       Experience conducting occupational/disability medical examinations. Compensation and Benefits: Pay and benefits are fundamental to any career decision. That's why we craft compensation packages that reflect the importance of the work we do for our customers. As a result, we offer meaningful and engaging careers to support you and your career goals, all while nurturing a healthy work-life balance. Employment benefits include competitive compensation, Health and Wellness programs, Income Protection, Paid Leave and Retirement. More details are available here.   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.  * This job description supersedes all prior job descriptions and is intended to describe the general content and essential requirements for the position listed above. It is not to be construed as an exhaustive statement of requirements, duties and responsibilities. Management reserves the right to add or change the duties of this position as required at any time. Nurses

Care Management Nurse (Future Opportunities) Remote within WA, OR, ID, UT. Candidates outside of these states will not be considered.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. **Please note this role is a candidate pool, and we are always looking for top talent. We do not always have open positions but we encourage you to submit your resume so you will be considered for all open roles as they become available.**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)#LI-RemoteThe expected hiring range for a Care Management Nurse is $38.00 - $41.50 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.

Base Salary Range:$88,919.56 - $155,609.24Looking 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.

Base Salary Range:$74,223.79 - $122,469.26Looking 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.