Clinical Programs Manager

2 weeks ago


Corvallis, Oregon, United States Samaritan Health Services Full time
Job Summary

We are seeking a highly skilled and experienced Clinical Programs Manager to join our team at Samaritan Health Services. As a key member of our Care Coordination department, you will be responsible for executing and implementing the Clinical Programs' strategy and goals, overseeing operations, and managing a team of clinical and support staff.

Key Responsibilities
  • Develop and implement clinical programs and strategies to improve healthcare outcomes and patient satisfaction
  • Oversee the effective integration and continuous improvement of processes and systems to meet Samaritan Health Plan's current and future business goals
  • Manage and develop a team of clinical and support staff, promoting their professional growth and operational effectiveness
  • Assure the development and maintenance of the infrastructure and procedures in cooperation with functional areas to promote the optimal performance of Medicaid, DSNP, SNP Model of Care, Medicare Advantage, and Commercial Members
  • Identify medical management initiatives, develop strategies, and deploy resources to reach corporate goals
  • Assist in evaluating the impact and effectiveness of initiatives
  • Work closely with the health plan clinical team to prioritize projects, identify medical trends, and develop processes to successfully respond to trends
Requirements
  • Current unencumbered Oregon RN License required within 90 days of hire
  • BSN preferred; Master's degree in a related field preferred
  • Five (5) years care management experience that included three (3) years leadership experience required
  • Experience in data analytics, project management, and process design
  • Healthcare delivery systems and/or managed care patients
  • Computer applications, including electronic documentation (e.g., MS Office, EPIC, Clinical Care Advanced)
  • Medicare and Medicaid rules and regulations and health plan benefit structure and policy
  • Case Management Certification (CCM) or Utilization Management Certification (MCG) preferred
Working Conditions

This role requires occasional travel to various locations within the approved states. The physical demands of this position include standing, walking, bending, and lifting up to 20 pounds.



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