Hybrid Clinical Operations Manager (RN/CCM)

Cascade Comprehensive Care; Klamath Falls (OR); Hybride; USD 95 000 - 125 000; Plein temps

Avantages offerts par ce poste

Vacation benefits

Medical, dental and vision insurance

401(k) retirement plan

Résumé du poste

Cascade Comprehensive Care in Oregon seeks a Clinical Operations Manager to oversee medical and dental authorization processes, care coordination, and regulatory compliance with Medicaid requirements. Responsibilities include leading utilization management, overseeing contract deliverables, and coordinating care across settings to achieve optimal outcomes while protecting patient privacy under HIPAA.

Required qualifications include a Bachelor's degree, an Oregon RN license, and CCM certification

Qualifications

• Bachelor's degree in a related field and 3–5 years' related experience.
• Oregon RN license required; CCM or equivalent within 18 months.
• Experience in utilization management and care coordination.
• Knowledge of Medicaid requirements and confidentiality rules.

Responsabilités

• Oversee medical/dental utilization review and authorizations.
• Lead care coordination across care settings to optimize outcomes.
• Ensure contract deliverables and regulatory compliance are met.
• Collaborate with DHS, clinics, and providers to improve processes.
• Maintain HIPAA compliance and protect patient privacy.

Connaissances

Communication skills

Presentation

Negotiation

Teamwork

HIPAA compliance

Attitude toward collaboration

Formation

Bachelor's degree

Oregon RN license

CCM certification within 18 months

Outils

Scheduling software

Project management tools

Description du poste

Cascade Comprehensive Care in Oregon seeks a Clinical Operations Manager to oversee medical and dental authorization processes, care coordination, and regulatory compliance with Medicaid requirements. Responsibilities include leading utilization management, overseeing contract deliverables, and coordinating care across settings to achieve optimal outcomes while protecting patient privacy under HIPAA.

Required qualifications include a Bachelor's degree, an Oregon RN license, and CCM certification