RN - Managed Care Program Manager

Job Brief

RN - Managed Care Program Manager Yakima, WA

Employment duration:
Full time
Exempt Status:
Exempt
Offer Relocation?:
Yes
ID:
12373

As the RN Managed Care Program Manager, you will lead and implement chronic care case management programs within our organization, specifically targeting patients at the highest risk. Your expertise will drive positive change, enhance patient care, and contribute to our mission of improving the health of our patients. We encourage you to apply if you’re passionate about making a difference and have experience working with and leading Chronic Care Case Management programs. This position is based in Yakima, WA, and is not remote. Relocation allowance is available.

What We Offer

Salary $87,000 -$116,000 DOE with ability to go higher for highly experienced candidates.
100% employer-paid health insurance for employees including Medical, Dental, Vision, Rx, 24/7 telemedicine; profit sharing, 403(b) retirement plan, generous paid time off, paid holidays, uniform allowance, and more.
Relocation allowance available.

Essential Functions/Responsibilities/Duties

Program Leadership:

Develop and oversee chronic care case management initiatives, focusing on high-risk patient populations.
Collaborate with interdisciplinary teams to create patient-centered strategies.
Monitor program outcomes and adjust as needed to optimize patient care.

Ensure Care Plan Implementation and adherence:

Develop and train staff on creating/writing care plans and documentation standards.
Ensure adherence to evidence-based practices and quality standards and advocate for preventive care and early intervention.

Population Health Strategies:

Analyze data to identify trends and opportunities for improvement.
Drive initiatives that enhance patient outcomes and reduce healthcare disparities.

Team Leadership:

Lead and mentor a team of RN care managers and healthcare professionals.
Foster a collaborative and supportive work environment.

Quality Assurance and Compliance:

Ensure compliance with regulatory requirements.
Monitor program quality and adherence to standards.
Participate in quality improvement efforts.

Qualifications

Education: Bachelor’s Degree in Nursing. Associates Degree and Two years’ additional directly related experience may be substituted for the required education. HS Diploma and Four years’ additional directly related experience may be substituted for the required education.
Experience: Five years’ experience in care coordination, case/care management, utilization/resource management, quality management, and/or transition of care. This includes two years’ experience supervising staff.
Professional Licenses/Certificates/Registration: Registered Nurse (RN) with current licensure to practice in Washington State. Case Management Certification (CCM) is preferred. If an RN license is in a participating Nurse Licensure Compact (NLC) state, the following requirements apply:
Must submit proof of license in the state of residence.
Must submit proof of completion for the required suicide prevention training during 1st week of onboarding.
If relocating to Washington State, obtain a WA RN license within 6 months of hire. Must update the primary state of residence within 60 days (applies to anyone relocating to Washington State)
Military Nurses are not required to obtain a Nurse Licensure Compact (NLC)
Knowledge/Skills/Abilities: Bilingual (English/Spanish) preferred. This position is not eligible for bilingual differential pay. Knowledge of utilization management, quality improvement, discharge planning, and cost management. Knowledge of the uses and effects of medications. Knowledge of cultural differences and ability to work effectively with culturally diverse populations. Effective verbal, written and listening communication skills. Skills to effectively lead and manage a department and a team. Skills to delegate responsibilities and motivate staff to complete tasks. Skills to exercise independent judgement and discretion. Skills to develop effective working relationships with social service providers, partners, referral/payer sources. Skills to effectively interact with a variety of patients, patients’ families and employees in a professional manner. Basic proficiency with a variety of computer programs including Microsoft Outlook, Word, Excel and PowerPoint.

Our mission celebrates diversity. We are committed to equal opportunity employment.