PacificSource Health Plans

Nurse, Health Management

US-OR-Eugene
Job ID
2017-433A
Type
Regular Full-Time
Hiring Pay Range
$67,000 - $72,000 a year
# of Openings
1
Status
Exempt

Overview

The primary focus of this position will be to assist members who are enrolled in Health Management programs to effect positive lifestyle and health-related changes to maximize quality of life/health and reduce utilization of healthcare resources over time. Collaborate with internal and external partners to facilitate coordination of care for program participants.

Responsibilities

  1. Follow established Health Management program procedures and processes to provide condition-specific coaching, interventions and education for selected members.
  2. Telephonically contact and coach members who are identified for specific condition interventions using evidence based motivational interviewing techniques to help program participants achieve a higher level of self-participation in improving their health.
  3. Ability to work flexible hours to accommodate member’s needs: Evening, early morning
  4. Collect, document, and assess patient information pertinent to member’s history, condition, and functional abilities
  5. Develop a comprehensive, individualized plan that promotes wellness, appropriate utilization, awareness, and understanding of condition self-management.
  6. Work collaboratively with PacificSource case managers, internal/external programs, Legacy team or healthcare providers for the purpose of coordinating care or addressing issues related to the condition(s) for which the member is enrolled.
  7. Assist and Coordinate with Health Management Health Service Reps around the Condition Support Program, as well as other Health Management programs and Legacy partnered programs.
  8. Research educational opportunities available within the member’s community or online that may maximize member learning opportunities.
  9. Accurately document case notes, assessments, contacts, and letters which may become part of legal records.
  10. Work collaboratively with other members of the team on program evaluation, development, implementation, and quality improvement activities related to health management programs. This includes development of written educational materials.
  11. Research condition specific and program information as needed to enhance/update existing, or develop new, programs.
  12. Work with other departments to develop or improve program processes and reports for the Health Plan, various employer groups and providers.

 

Supporting Responsibilities:

  1. Act as back-up for other Health Services department staff and functions, as needed.
  2. Assist and/or lead NCQA compliance for internal disease management program/population health in conjunction with Health Services team.
  3. Work on designated committees, teams, and task groups, or team projects including group presentations as assigned.
  4. Represent the Health Services department, both internally and externally, as requested.
  5. Meet department and company performance and attendance expectations.
  6. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
  7. Perform other duties as assigned.

Qualifications

Work Experience: Five years nursing experience with varied clinical experience. Experience in health coaching, disease management, and/or chronic condition management (adults or children) preferred. 

 

Education, Certificates, Licenses: Registered Nurse with current Oregon License. Willingness to obtain RN licensure in other states as requested.

 

Knowledge: Pediatric & adult health teaching & coaching, including understanding of motivational interviewing techniques. Experience with program development, implementation, and management. Work effectively with people who have a variety of health issues, concerns, and personality styles. Is knowledgeable about, or has the research skills to locate, community services, providers, vendors and facilities available to assist members.  Maintain clinical knowledge base. Effective technical writing skills. Good organizational skills with experience in using computers and various software applications including Word, Excel, PowerPoint, and Outlook.

Ability to work independently with minimal direction.

 

Competencies

Our Values

  • Building Trust
  • Building a Successful Team
  • Aligning Performance for Success
  • Building Strategic Work Relationships 
  • Continuous Improvement
  • Facilitating Change
  • Leveraging Diversity
  • Driving for Results
  • Building Customer Loyalty
  • Decision Making

 

 

  • We are committed to doing the right thing.
  • We are one team working toward a common goal.
  • We are each responsible for our customers' experience.
  • We practice open communication at all levels of the company to foster individual, team and company growth.
  • We actively participate in efforts to improve our many communities-internal and external.
  • We encourage creativity, innovation, continuous improvement, and the pursuit of excellence.

 

 

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. May be asked to flex hours to accommodate telephonic contact with members in the evening or, periodically, on weekends.

 

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

 

Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

 

PacificSource is an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.

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