Utilization Manager Jobs in Springfield, OR (NOW HIRING)

Description

PeaceHealth is seeking a RN Complex Care Manager Outpatient - Care Mgmt for a Full Time, 1.00 FTE, Day position. 

The salary range for this job opening at PeaceHealth is 48.52 - 72.78. 

The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

Job Summary

Oversees and evaluates coordination of integrated population management across selected populations to improve clinical and financial outcomes. Develops care management programs addressing a wide scope of health care needs and conditions in partnership with physicians, health care professionals and patients. Identifies, coordinates, and case manages a panel of clinically high-risk complex patients and provides oversight for caregivers who manage patients at moderate or low risk.

Essential Functions

• Accountable for development and continuous evaluation and assessment of population management programs, tools and delivery of care coordination services. Collaborates with system and regional leadership to optimize processes and metrics.

• Risk-stratifies patients according to protocols, assesses patient data, and works within interdisciplinary care team to assess patient's physical, cognitive, emotional and behavioral status as well as social and financial support systems.

• Works with patients and families to create and implement a care plan that meets identified needs and incorporates services that improve outcomes. Adjusts care plan to patient activation and risk levels through ongoing monitoring of patient.

• Delegates and oversees the care management of lower-risk patients as well as routine chronic disease population management tasks to assigned caregivers.

• Tracks, evaluates, and provides oversight for transitions of care, synchronizing "warm handoffs" between the clinic and hospitals, emergency departments or care facilities. Facilitates and ensures the sharing of information across people, functions, and sites.

• Demonstrates leadership, mentorship and teamwork within dedicated care teams including clinicians, chronic disease care coordinators, medical assistants, pharmacists, social workers and others.

• Performs other duties as assigned.

Qualifications

• Associate Degree Required: Nursing and

• Bachelor's Degree Preferred: Bachelor of Science in Nursing or

• Master's Degree Preferred: Master of Science in Nursing

• Minimum of 3 years Required: clinical nursing experience in an ambulatory or clinic setting and

• Preferred: Care Management or Care Coordination experience and

• Preferred: Utilization management/quality management experience

Credentials

• Required: Registered Nurse in state of practice and

• Required: Upon Hire Basic Life Support and

• Preferred: within 2 years Care Manager Certified

Skills

• Basic knowledge of statistics (Required)

• Skill and proficiency in applying highly technical nursing principles, concepts, and techniques (Required)

• Interpersonal skills to obtain and interpret information appropriate to patients' needs and age as required for assessment range of treatment, and patient care. (Required)

• Demonstrated ability to promote positive interpersonal relationships and patient/family centered work environment. (Required)

• Demonstrated ability to delegate and supervise the performance of tasks. (Required)

• Demonstrated ability to provide training, mentorship and development to clinic staff. (Required)

• Basic computer skills including MS Office applications (Required)

• Effective prioritization skills (Required)

• Skill and proficiency in applying highly technical principles, concepts, and techniques. (Required)

Department / Location Specific Notes

Oregon West Network:

• Educational experience: deliver patient education and teaching including medication injections and medical equipment training (Glucometer).
• Lengthy computer work on reports and clinical chart may be required.
• Responsibilities may include travel to and from clinic sites at multiple locations.
• For grant projects: may be required to manage all metric reporting on clinical data and outcomes for the patient population reporting under the grant.

PHMG Ambulatory Care Management:

• Educational experience: deliver patient education and teaching including medication injections and medical equipment training (Glucometer).
• Lengthy computer work on reports and clinical chart may be required.
• Ability to work in an independent and remote environment as position may be a hybrid of onsite and remote work.
• Ability to work from home in a secure environment free of distractions with appropriate high-speed connectivity
• Responsibilities may include travel to and from clinic sites at multiple locations.

Working Conditions

• Patient handling no greater than 35 lbs. without the use of assistive equipment and/or devices (NIOSH).

• Fine motor skills to be able to grasp and control medical equipment and perform precise procedures.

• Push/Pull: Frequently up to 45 lbs. force (i.e., WOW, medical carts).

• Perform hands on CPR at least 20 mins using 100-125 lbs. of force (National Assoc. of EMS Physicians and AHA) Frequency should be seldom or occasionally.

• Ability to move around area with frequent sitting.

• Bending/ stooping/ squatting/ reaching/ kneeling frequently.

• Lifting (non-patient) up to 20 lbs. occasionally and 5 lbs. frequently.

• Exposure to biohazard, body fluids and airborne particles.

• Must be able to complete tasks in a noisy environment.

• Vision and hearing required within normal limits (glasses, contacts, hearing aids permitted).

• Ability to communicate and exchange accurate information.

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.