• Job Description

  Req#: 2049693

  • Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.

    As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.

    Candidates residing out of state will need to be able to work Pacific Time Zone hours.

    This is a remote position in which we are able to employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

  • JOB SUMMARY/PURPOSE

    • Utilizes clinical knowledge and system improvement skills to support SHP Behavioral Health Care Coordination services. Supports contract compliance, OAR’s, and system transformation. Seeks system coordination with the focus on whole person health integration. Utilizes knowledge of Medicaid, continuum of care, knowledge of state and CCO regulations and gap identification for constructive support and change. Supports the oversight and monitoring of treatment-based services.

  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Master's degree in Mental Health, Social Work, Clinical Psychology or a closely related field required.
    • Current unencumbered Oregon credential/licensure in one (1) of the following required:
      • Licensed Clinical Social Worker (LCSW).
      • Licensed Professional Counselor (LPC).
      • Licensed Psychologist (PhD or PsyD).
      • Clinical Social Work Associate (CSWA).
      • Licensed Master of Social Work (LMSW).
      • Licensed Marriage and Family Therapist (LMFT).
    • Five (5) years care management experience that included three (3) years leadership experience required.
    • Experience in the following required:
      • Development and application of public policy.
      • Data analytics, project management and process design.
      • Health care 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.
      • Health equity and trauma informed care practices.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
    • Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
    • Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
    • Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.
  • PHYSICAL DEMANDS

    • Rarely (1 - 10% of the time)	Occasionally (11 - 33% of the time)	Frequently (34 - 66% of the time)	Continually (67 – 100% of the time)
      LIFT (Floor to Waist: 0"-36") 0-20 Lbs LIFT (Knee to chest: 24"-54") 0 - 20 Lbs LIFT (Waist to Eye: up to 54") 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds CARRY 2-handed, 0 - 20 pounds KNEEL (on knees) BEND FORWARD at waist CLIMB - STAIRS	STAND WALK - LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0-20 pounds force) PULL (0-20 pounds force)	SIT ROTATE TRUNK Sitting REACH - Forward MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist	None specified

• About the company

  The Samaritan Health Services is a non-profit, integrated delivery healthcare system consisting of five hospitals in Oregon and is headquartered in Corvallis, Oregon.

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