Utilization Case Manager Jobs in Oregon (NOW HIRING)

You are the voice, the coordinator and the empathetic advocate of patients facing difficult situations. Your compassion for patients and families with acute and chronic health conditions knows no limits. You are committed to working with healthcare teams to ensure every patient receives the care, comfort and dignity they deserve. If this is how you define your role as a Case Manager, we invite you to consider this opportunity.

• 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.

Education:

• Academic degree in nursing (BSN or higher) preferred.

Experience:

• This 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 resources
  • Care management of diverse patient populations
  • Ambulatory 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/Skills:

• Knowledge of six core components of case management:
  • Psychosocial aspects
  • Healthcare reimbursement
  • Rehabilitation
  • Healthcare management and delivery
  • Principles of practice i.e.  CMS guidelines, Interqual criteria
  • Case 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.

• Current applicable state RN licensure. 
• Case management certification preferred. 
• BLS for Healthcare Providers from the American Heart Association required for all employees who perform this job in the state of Oregon.

Our Legacy is good for health for Our People, Our Patients, Our Communities, Our World. Above all, we will do the right thing.

If you are passionate about our mission and believe you can contribute to our team, we encourage you to apply—even if you don't meet every qualification listed. We are committed to fostering an inclusive environment where everyone can grow and succeed.

Legacy Health is an equal opportunity employer and prohibits unlawful discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion or creed, citizenship status, sex, sexual orientation, gender identity, pregnancy, age, national origin, disability status, genetic information, veteran status, or any other characteristic protected by law.

To learn more about our employee benefits click here: www.legacyhealth.org/For-Health-Professionals/careers/benefiting-you