This position will be remote or hybrid (remote and on-site in Corvallis) and is eligible for up to a $5,000 sign on bonus.
Serves as a single entry or "easy access" point to help members and providers navigate through managed care. Applies knowledge of applicable regulations, identifies resources (internal or community partners) and eliminates barriers where possible. Provides care management interventions and seamless support across transitions of care.
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health 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.
- Master's degree in Mental Health, Social Work, Clinical Psychology or a closely related field required.
- Current unencumbered Oregon licensure in one (1) of the following required within six (6) months of hire:
- Licensed Clinical Social Worker (LCSW).
- Clinical Social Work Associate (CSWA).
- Licensed Master of Social Work (LMSW).
- Licensed Professional Counselor (LPC).
- Licensed Psychologist (PhD or PsyD).
- Experience and/or training in the following required:
- Behavioral Health care delivery systems and/or managed care patients.
- Computer applications including electronic documentation.
- Experience in the following preferred:
- Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
- Communication - Effective written and verbal communication skills provided to members, providers and organization staff. Able to tactfully discuss issues, and listen to and understand complex information/situations. Ability to apply motivational interview techniques when working with members. Proactively resolve conflicts in positive and constructive manner.
- Confidentiality - Knowledge of State and Federal (HIPAA) laws pertaining to confidentiality of protected health information. Ability to comply with laws and maintain confidentiality of patient information.
- 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 in a member centric manner.
- Social Perceptiveness - Ability to work with a diverse population from pediatrics to geriatrics. Basic understanding of age-related differences in caring for and/or communicating with members and caregivers. Possess personal sensitivity to the needs and experiences of others and a non-judgmental attitude towards persons of differing standards, values, lifestyles, and ages.
- Knowledge of Medicare and Medicaid rules and regulations and health plan benefit structure and policy. Ability to appropriately apply evidence based clinical practice and criteria to authorization requests.
ABOUT THE AREA
The city of Corvallis is situated in the middle of Oregon’s Willamette Valley. It’s located within 90 minutes of the Portland metropolitan area, world-class skiing, Oregon’s famous wine country and the spectacular Oregon coast. Corvallis has a residential population of nearly 55,000 and is home to the Pac-12’s Oregon State University. Spend the day savoring Northwest cuisine, sipping local wine, browsing the farmers market or strolling along the river. Head outdoors and you’ll find world-class mountain biking, cycling, golfing and hiking.