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Nurse Case Manager
Posted Monday, July 17, 2023
Posting ID: JP-003910799
Hiring a remote Nurse Case Manager in Portland area for a local hospital
* This position is remote* Must sit within 50 miles of Portland
• Includes interfacing with NWP clinicians, community providers and members to ensure the member receives high quality, safe, efficient and timely medical services
• Preview and preapprove requests for referral to community clinicians and/or programs for medically necessary services as requested by the NWP clinician.
• Work directly with the member and the community clinician to coordinate medical services, providing accurate and timely information to the community physician and member related to requested services.
• With Community Medicine Integration Center leadership, insures compliance with regulatory and accrediting requirements for utilization of referred services, including NCQA, MDQR, Federal and State agencies.
Triage and advice, care planning, receiving escalations form LPNs, making appointments , Post hospital assessments, case management
SCHEDULE: Monday - Friday, 8:00 AM - 5:00 PM (40 hours/week)
*Note: Some weekend shifts may be required.
Skills and Qualifications
• Current Oregon and Washington RN license
• Basic Life Support certification (BLS) - MUST be through the American Heart Association
• High School Diploma or GED
• Valid Driver's License
• EMR/EHR experience
• Minimum two (2) years of experience in case management, care coordination, or population care.
• Minimum two (2) years of direct patient care as a registered nurse.
• Knowledge of case management principles.
• Knowledge of Oregon Health Plan, including ORS requirements, pharmacy rules and regulations and OHP list of treatable diseases.
• Knowledge of community resources for the care of the elderly and disabled.
• Demonstrates customer-focused service skills.
• Demonstrated ability to organize, coordinate, and manage care plans. Thorough knowledge of levels of care within outpatient, acute
care, and extended care settings.
• Demonstrated ability to work as part of a multidisciplinary team.
• Excellent written and verbal communication skills.
• Ability to present reports verbally in a public setting (public speaking).
• Demonstrated data entry skills and ability to use Microsoft Word software.
• Ability to work independently and efficiently under pressure