Pharmacy Director (Health Plan) - Hybrid Nonprofit Role Yamhill Community CarePharmacy Director (Health Plan) - Hybrid Nonprofit RoleMcMinnville, ORRemoteDevelops and implements quality improvement initiatives focused on medication adherence and outcomes improvement programs to address health disparities in medication use and outcomes, prioritizing Oregon's equity goals. This role oversees Pharmacy Benefit Management (PBM) subcontractor implementation and internal operations, formulary alignment with the Oregon Preferred Drug List (PDL), and programs addressing cost, utilization, and quality outcomes.
Director, Healthcare Services - REMOTE Molina Healthcare IncDirector, Healthcare Services - REMOTEVancouver, WARemoteRegistered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). At least 8 years of health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
Remote Registered Nurse RN RylemRemote Registered Nurse RNPortland, ORRemote$25–$28 / hourFull timePart timeWe’re looking for an experienced Registered Nurse Clinical Documentation Specialist to join a high-performing healthcare team in a fully remote role! If you have a strong CDI background and acute care experience, this is your chance to work from home while earning competitive travel pay.
Registered Nurse RN Case Manager DaVita Inc.Registered Nurse RN Case ManagerSalem, ORRemoteIn lieu of case management experience, 3 or more years of experience assessing patient needs, developing and managing individualized care plans, coordinating services across interdisciplinary teams, and supporting patients through complex healthcare transitions is required. Our more than 600 dedicated nurses, care coordinators, nurse practitioners (NPs) and business professionals integrate and manage care for more than 20,000 patients with late-stage chronic kidney disease (CKD) and end stage renal disease (ESRD) across the US each month.
NewRemote Call Center Triage Registered Nurse CVS Health CorpRemote Call Center Triage Registered NurseORRemote$26.01–$74.78 / hourThe progression path from Level I to Level II positions within the Triage RN team is a structured path that encourages nurses to widen their knowledge base, take on more responsibility, demonstrate expertise, and reward team members for their proven success and dedication. Role Description: The Clinical Call Center Triage Nurse effectively extends care during and outside of regular Oak Street Health clinic hours by addressing patients' medical, social, and psychological needs telephonically.
Public Health Nurse II Clark County, WAPublic Health Nurse IIVancouver, WARemote$39.34–$53.10 / hourDevelop partnerships with Department of Social and Health Services (DSHS), relevant Department of Health (DOH) programs (Communicable Disease Epidemiology, Public Health Laboratory, Information Resources Management Division, Communications Office, Health Systems Quality Assurance Division), the Centers for Disease Control and Prevention (CDC), and other national associations. Provide consultation, assessment and technical expertise to public health partners, health care providers, and community stakeholders and collaborate with local, state, and regional partners to effectively prevent and control HAIs, respiratory and GI illnesses, and multiple drug resistant organisms (MDROs).
Utilization Management Manager – Remote Nonprofit Role Yamhill Community CareUtilization Management Manager – Remote Nonprofit RoleMcMinnville, ORRemoteACM (Accredited Case Manager) through AMCA (American Case Management Association), CCM (Certified Case Manager) CCMC (Commission for Case Manager Certification), Board certification in Nursing Case Management (RN-BC) through ANCC (American Nurses Credentialing Center), CPHQ (Certified Professional in Health Care Quality) through NAHQ (National Association of Health Care Quality). Master’s degree in Nursing or other Healthcare related field, Five (5) years of relevant clinical nursing or healthcare related experience, Experienced in physical and behavioral health integration, Experience with Coordinated Care Organization (CCO) / Medicaid Managed Care, Three (3+) years of experience with Utilizations Management, Equivalent combination of education and experience will be considered.
Public Health Nurse II Clark County WashingtonPublic Health Nurse IIWARemote$39.34–$53.10 / hourDevelop partnerships with Department of Social and Health Services (DSHS), relevant Department of Health (DOH) programs (Communicable Disease Epidemiology, Public Health Laboratory, Information Resources Management Division, Communications Office, Health Systems Quality Assurance Division), the Centers for Disease Control and Prevention (CDC), and other national associations. Provide consultation, assessment and technical expertise to public health partners, health care providers, and community stakeholders and collaborate with local, state, and regional partners to effectively prevent and control HAIs, respiratory and GI illnesses, and multiple drug resistant organisms (MDROs).
NewClinical Review Nurse - Concurrent Review Actalent IncClinical Review Nurse - Concurrent ReviewPortland, ORRemote$36–$40 / hourThe Utilization Review Registered Nurse evaluates clinical information, applies medical necessity criteria, collaborates with healthcare providers and internal medical teams, and supports discharge planning and care coordination across the continuum of care. This role focuses on performing comprehensive concurrent and utilization reviews to ensure members receive medically necessary, high-quality, and cost-effective care at the appropriate level and setting.
RN Health Care Facility Surveyor Impact Recruiting SolutionsRN Health Care Facility SurveyorOregon City, OregonRemote$75,000–$90,000The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.
NewDirector of Sales & Business Development Harris Computer SystemsDirector of Sales & Business DevelopmentORRemote$80,000–$110,000 / yearYou'll work alongside experienced professionals, including a professional services team comprised of Registered Nurses and former perioperative staff, who bring deep clinical expertise and a customer-centric perspective to every challenge. About Picis: Join Picis, a global leader in perioperative and critical-care information systems, where you'll be part of a team that is genuinely pleased with their colleagues and thrives in a positive, comfortably fast-paced environment.
RN Care Navigator/Case Manager - 100% Remote (Compact State & Oregon RN licenses are required) Healthmap Solutions IncRN Care Navigator/Case Manager - 100% Remote (Compact State & Oregon RN licenses are required)ORRemoteManaging a set caseload of mixed acuity members, reviewing and/or obtaining member data and entry in HealthMap's Care Management documentation system (Compass), completing member health and social determinants of health screenings, medication reconciliation, creation and maintaining member-centric care plans, updates of identified problems, barriers, interventions, and goals and assistance with ongoing case management. Serve as liaison between the patient, the patient's support network, treating physician, and other ancillary providers as a member of an interdisciplinary care team to coordinate care, resolve nursing problems and assist patients in meeting individualized goals.
Manager, Clinical Quality TriWest Healthcare AllianceManager, Clinical QualityPortland, ORRemoteFull timeTechnical Skills: Proficient with the Microsoft Office suite of applications; thorough knowledge of TRICARE policies and procedures; comprehensive knowledge of research methodology that supports evaluation of potential quality issues and/or serious reportable events; proficient applying appropriate data analysis processes; knowledge of managed care principles and methods; knowledge in the application of clinical criteria. Responsible for leading and directing a team of clinical and non-clinical staff that provide Clinical Quality Review services and interventions for beneficiaries and providers under the direction of the Director of Clinical Quality Management (CQM).
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorOregon City, ORRemote$75,000–$90,000 / yearThe Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide.