Clinical Program Coordinator RN, Maternity / Pediatrics *Remote*
About the position Responsibilities • Support the commercial insurance based line of business for cases including Maternity, Pediatrics, Transplant, and Pain Management. • Provide care coordination, case management, and care management services to Providence Health Plans (PHP) members. • Conduct triage and referral, transition of care planning, and acute and catastrophic case management. • Assist with nurse education, care coordination, and managing day-to-day functional needs of members. • Help manage member health plan benefits and find alternative services when benefits are exhausted. • Work to improve access and quality care for members. Requirements • 5+ years of clinical nursing experience. • Experience working with physicians in the collaboration and management of patient care. • Current unencumbered Registered Nurse License in state of residency. Nice-to-haves • Bachelor's Degree in Nursing or Health Education. • Current unencumbered Registered Nurse License in Oregon upon hire. • Current unencumbered Registered Nurse License in Washington State within six months of hire date. • Case Management Experience (e.g., Triage and Referral, Transition of Care Planning, Discharge Planning). • Utilization Management Experience (e.g., Concurrent Review, Prior Authorization, Medical Audits). • Experience working in a health plan or medical insurance plan. • Current nursing experience in chronic pain management, cardiology, pediatrics, or maternity. Benefits • 401(k) Savings Plan with employer matching • Health care benefits (medical, dental, vision) • Life insurance • Disability insurance • Paid parental leave • Vacation and holiday time off • Voluntary benefits • Well-being resources Apply tot his job