Managed Care Coordinator jobs in Oregon

We are currently hiring a Nurse Care Coordinator, onsite and remote work opportunities available! If you are an experienced behavioral health nurse, skilled in case management, an effective motivational interview, and value being part of a team that makes a difference, you may be the right person for the position! Apply today!

JOB SPECIFICATIONS
Classification: Non-exempt | Status: Full-time, Monday - Friday, generally 8am to 5pm, Pacific Time
Salary: $33.26 - $49.88/hourly
Department: Intensive Care Coordination | Work Location: Coos Bay
Reports to: Director of Care Coordination | Supervision Exercised: Non-supervisory

JOB PURPOSE: Care Coordination Nurse
The Intensive Care Coordination (ICC) program is a collaborative, comprehensive, integrated and interdisciplinary-focused Coordinated Care Organization (CCO) program staffed with team members focused on the addressing interrelated medical, social, cultural, developmental, behavioral, educational, spiritual and financial needs in order to achieve optimal health and wellness outcomes for each member in need.

This position is responsible for providing member focused assessment, care planning and service coordination for members with high health care needs, including members with complex behavioral concerns, severe and persistent mental illness, substance use disorders, and/or receiving facility based, in-home or community-based psychiatric services. The ICC Nurse utilizes clinical expertise and assessment in behavioral and mental health conditions, and alcohol and other drug related addiction (AOD) treatment in coordinating services for the purpose of improving member self-management and overall health outcomes. This position is also responsible for assisting in auditing, reporting and oversight of external ICC teams and provides network support.

QUALIFICATIONS, EDUCATION, and EXPERIENCE

• Assess for and identify care coordination needs in order to implement ICC program to members

• Identify risk factors and service needs that may impact member outcomes and address per guidelines

• Utilize a trauma-informed approach to provide member-focused care and support

• Assist in helping members move through the continuum of care based on clinical/medical need

• Utilize assessment information to develop individualized care plans for assigned members

• Coordinate with providers to ensure consideration is given to unique needs in integrated planning and that care plans are timely and effective

• Identify suspected abuse and neglect issues and appropriately report to mandated authorities

• Implement care coordination plan in collaboration with member, providers, case workers and other relevant parties

• Work closely and collaborate with behavioral health treatment providers, crisis services, Developmental Disability, APD, DHS, etc.

• Provide face to face, telephonic, videoconference and community-based care coordination to eligible members and families

• Assist members and families access the care and services they need without barriers

• Provide support and coordination for members receiving treatment in the higher levels of behavioral health care such as psychiatric residential treatment, intensive community based or psychiatric day treatment

• Ensure treatment recommendations are understood by the member and provider, and assist members through transitions to the next level of care or treatment provider

• Facilitate communication between members, their support systems other community-based partners and clinical care providers and ensure care plans are shared, as appropriate

• Accept assignment of and maintain a caseload of members

• Participate in an interdisciplinary team for integrated care plan support of complex members

• Collaborate with community providers, state and county case workers, community partners, vendors, agencies, provider network, wraparound teams, and other relevant parties

• Provide direction as appropriate to non-clinical Care Coordination staff involved with the member

• Assist in transition/discharge planning for members discharging from acute care settings or those who are transitioning from long term care, the Oregon State Hospital, or other residential facilities to ensure a smooth transition back to community-based supports

• Ensure discharge/transition plans are evaluated holistically from physical and behavioral health perspectives; may participate in monthly discharge planning meetings

• Coordinate care for members residing outside of service area as required in contract

• Forward relevant information of members requiring special consideration of benefits to Medical Management Review RNs or to affiliated Advanced Health programs

• Serve as a resource to the organization on mental health and alcohol and other drug topics and issues

• May provide coaching and training on specific job responsibilities to new employees, QMHP and/or Traditional Healthcare Workers (THW) in ICC team

• Ensure compliance with company policies and procedures as applicable to area(s) of responsibility

• Handle confidential information and materials appropriately and maintains a secure work area

• Other duties as assigned

• Ensure compliance with company policies and procedures as applicable to area(s) of responsibility

• Handle confidential information and materials appropriately and maintain a secure work area

• Other duties as assigned

WORKING CONDITIONS
This position must have the ability to remain in a stationary position, occasionally move about inside the office to access office machinery, printer, etc., frequently communicate and exchange accurate information.

Work Condition: Hybrid Work Environment

This job description is intended to provide only basic guidelines for meeting job requirements. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of DOCS Management Services employees. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.