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Clinical case manager jobs in Coeur dAlene, ID

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  • Legal Case Manager

    The Advocates 4.4company rating

    Clinical case manager job in Spokane, WA

    Who We Are The Advocates are a growing personal injury law firm with branches across the United States. We are dedicated to representing victims of accidents with care and respect. Our team genuinely cares about and has empathy for the people who seek our help, and we are driven to get them the best results possible. The PNW branch is looking for a driven and client-focused Case Manager to be a part of our Spokane office. You would become a vital part of a close-knit group of attorneys, legal assistants, paralegals, and staff who all share a profound dedication to supporting our clients throughout their recovery journeys. Learn more about us at our website! https://www.advocateslaw.com/ Our Ideal Candidate We are looking for a Legal Case Manager to join our growing team. The position will have ownership over cases, reaching out to coordinate with clients, solving problems with insurance companies and medical providers, and organizing records. They will work hand-in-hand with an attorney to provide excellent service to people who have been hurt. A great fit would be someone who is extremely friendly and people-oriented, has a history of working hard for clients, appreciates the connection between details and client success, and is emotionally and intellectually sharp. Responsibilities Feel a sense of responsibility for the cases on your docket Communicate with clients throughout the course of their treatment Collaborate with team, including other assistants and attorneys to ensure top notch client representation Are driven to win and take pride in your work Provide exceptional customer service to both external and internal clients with a professional, courteous manner. Perform administrative duties such as gathering, recording, and filing documentation Experience and Professional Background Computer literacy (required) High School Diploma or GED (required) Associate's Degree (preferred) 1+ years Office Work experience (preferred) 1+ years of Personal Injury experience (preferred) Spanish fluency (preferred) Skills Solving complex problems on the phone Persistent and dedicated in case management Able to develop strong rapport with clients and providers Eager to learn complex tasks Compensation $23.00 - $26.00/hour Health, Dental, and Vision care up to 100% employer paid (Buy up options available) Employee Assistance Program 3 Weeks PTO in year 1, Uncapped PTO in year 4 401(k) matching up to 4% (after 1 year) 50% Paid STA Connect Card
    $23-26 hourly Auto-Apply 8d ago
  • Advanced Vocational English Case Manager (Part-time)

    World Relief 3.9company rating

    Clinical case manager job in Spokane, WA

    Are you a person of compassion? An advocate for justice? Someone who stands up for the rights of the vulnerable and speaks out for the marginalized, the exploited and the forgotten? Do you believe in our calling as Christians to welcome the least of these and love our neighbor? If you answered ‘yes', to any of the above, World Relief, and millions of people around the world need you. At this pivotal moment in time, we are rapidly expanding and growing our team to meet the increasing needs of our world. We are looking for people who want to use their gifts and talents to make a real and tangible difference in our world and the lives of the suffering. If you're looking for a purpose-driven career in which you can grow your talents, while also standing up for the rights of the vulnerable, we want you to join us today. ORGANIZATION SUMMARYWorld Relief is a global Christian humanitarian organization whose mission is to boldly engage the world's greatest crises in partnership with the church. The organization was founded in the aftermath of World War II to respond to the urgent humanitarian needs of war-torn Europe. Since then, for 80 years, across 100 countries, World Relief has partnered with local churches and communities to build a world where families thrive and communities flourish. Today, organizational programming focuses on humanitarian and disaster response, community strengthening and resilience, and refugee & immigrant services and advocacy. This position is reliant upon funding and may be subject to modification or termination based on resource availability. POSITION SUMMARY:World Relief seeks an Advanced Vocational English Case Manager to support and empower newcomers as they work toward long-term career goals through providing Advanced Vocational English tutoring and coaching individuals and small groups. This part-time position is for 30 hours per week.ROLE & RESPONSIBILITIES: Address the vocational English needs of program participants and coordinate tutoring and coaching to meet these needs. Attend regular screenings and enrollments with other Career Pathways staff, to review and create new participant career plans. Coordinate Advanced Vocational English small groups tailored to the current needs of program participants. Identify, utilize and tailor advanced vocational English curriculum to use in small group tutoring. Prepare and distribute learning materials and supportive supplies to each client as needed/requested. Supervise interns and/or volunteers for tutoring and small group support as needed/available. Develop and deliver digital literacy coaching as needed. Manage computer loaner programs. Create assessments to evaluate readiness for a variety of educational and vocational opportunities. Be familiar with program guidelines and requirements. Careful tracking, record keeping and reporting in multiple database systems. Participate in required department and all-staff meetings. Other duties as assigned. JOB REQUIREMENTS: Mature and personal Christian faith Committed to the mission, vision, and values of World Relief Desire to serve and empower the Church to impact vulnerable communities Able to affirm and/or acknowledge World Reliefs Core Beliefs, Statement of Faith, Christian Identity and National Association of Evangelicals' For the Health of The Nation document Experience working cross culturally and non-native English speakers Bachelor's degree or higher, preferably in TESL/TESOL or a similar content area Valid driver's license, access to reliable vehicle and clean driving record PREFERRED QUALIFICATIONS: Excellent communication skills, both orally and in writing 1-year minimum experience in case management and group facilitation, including over virtual platforms Ability to complete tasks independently, thoroughly, and on time Flexible and adaptable to needs of students and changing program realities Ability to communicate well and work closely with a team Ability to use Windows and Microsoft software (including Word, Outlook, Teams, and PowerPoint), and Zoom Working knowledge of phone and laptop functionality World Relief offers a competitive benefits package and employee discount program for full-time, Regular, and part-time (25+ hours per week) employees World Relief is honored to be recognized with the Gold-level Cigna Healthy Workforce Designation for exceeding the core components of our well-being program including leadership and culture, program foundations and execution, and whole person health. ***Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. We are proud to be an EEO/AA employer M/F/D/V. We maintain a drug-free workplace and perform pre-employment substance abuse testing. For World Relief staff, strong commitment to the mission, vision, and values of World Relief is essential, and Christian faith is a prerequisite for employment, based upon United States federal guidelines provided in Title VII of the Civil Rights Act of 1964.
    $48k-55k yearly est. Auto-Apply 45d ago
  • Temporary Case Manager - The Way Out Center

    The Salvation Army Northwest Division 4.0company rating

    Clinical case manager job in Spokane, WA

    Job Description DEPARTMENT: THE WAY OUT CENTER CASE MANAGER STATUS: TEMPORARY FULL-TIME, NON-EXEMPT SUPERVISOR: PROGRAM MANAGER MISSION STATEMENT: The Salvation Army, an international movement, is an evangelical part of the universal Christian Church. Its message is based on the Bible. Its ministry is motivated by the love of God. Its mission is to preach the gospel of Jesus Christ to meet human needs in His name without discrimination. SCOPE OF POSITION: The Case Manager may provide front-line homeless outreach services to engage, enroll, navigate, and ultimately provide center/housing referrals to individuals experiencing homelessness from the streets into The Way Out Center or more appropriate temporary housing options. This positions responsibilities occur in multiple potential settings: front desk coverage at The Way Out Center, Community Partner Agencies (Emergency Center, Social Service Agencies, Mental Health/Substance Abuse Treatment Partner Agencies, Community Corrections/Jail/Prison, etc.), and any other place that individuals experiencing homelessness congregate. The Case Manager also provides support to individuals residing at The Way Out Center to help program participants regain control of their lives through recovery from addiction, mental health issues, and substance use challenges while seeking permanent housing. This involves working with individuals to identify goals and making progress toward those goals, helping them to get housing readiness trainings, permanent housing, and achieve housing stability. The Case Manager may have contact with the public or office environments that may risk exposure to irrational/hostile behavior, typical/extreme weather conditions, contagious parasites/diseases, or contact with domestic animals. EDUCATION AND WORK EXPERIENCE: Associate's Degree required, Bachelor's Degree preferred 12 months direct work experience with individuals experiencing homelessness KNOWLEDGE, SKILLS AND ABILITIES REQUIRED: Knowledge of social services, local resources and referrals as appropriate Possess general computer and keyboarding skills Knowledge of Microsoft Office (Word, Excel), recordkeeping systems, or willing to learn Effective communication, both verbally and in writing Demonstrate effective personal and situational awareness Flexible, relatable, and reliable Self-motivated and work with minimum supervision Be an active listener by asking questions and reflecting what is being said Maintain healthy boundaries with participants and fellow staff members Manage time effectively Make decisions based on Established Policies and Procedures manual Support Recovery and Resiliency in participants with mental health issues, substance use challenges Model tools and techniques to assist participants with mental health issues, and/or substance use challenges obtain and maintain permanent housing Successfully participate in TSA Spokane's Employee Development training program Skills Training interventions that support participants in achieving recovery goals Impact of income on participants benefits (SSDI, SSI, Food Stamps, Housing Subsidies) Provide social services, local resources, and referrals as appropriate Peer Support Certification preferred; required within 90 days of hire Over 21 years of age Possess a Valid Driver's License Pass a Criminal and Driver Background Check Have or complete De-escalation training Proficiency with CMIS/HMIS software preferred Current WA State Food Handler's Card, Bloodborne Pathogen and CPR/First Aid Certification or obtain within 30 days of hire ESSENTIAL DUTIES AND RESPONSIBILITES: Represent The Salvation Army and respect and work within its Christian tenets Provide outreach services outside The Way Out Center to recruit program applicants Aid program applicants to gather or request photo ID, birth certificates, mental health and substance abuse evaluations, disability services and employment Provide support, information and referral services as appropriate to program applicants Establish/maintain professional, respectful and positive relationships with coworkers, applicants and community partners Complete the pre-screen and application process alongside the applicant Address applicants needs/concerns fairly and professionally; coordinate with supervision Develop/maintain strong ties to the community, law enforcement, and other homeless service providers Complete applicant's placement into the center once approved Manage the front desk area when required Assist participants by engagement, case management, community resources, and services to support their housing search efforts to achieve permanent housing stability Provide and advocate for any effective recovery based services that will aid the participant in daily living Identify barriers to permanent housing and develop strategies to overcome those barriers Develop a collaborative individualized, strengths-based case plan inclusive of action steps for permanent housing search related issues Work with the participant to set goals and develop a Permanent Housing Plan with the assistance of the case management Update the Case plan as the participants needs and circumstances change Complete progress notes to document the participants progress toward housing and permanent housing stability Provide coaching, advocacy, information, and referral, linkage and coordination with resources, and ongoing supports Assist with completion of required paperwork Share lived experiences to support the individual in the housing search process Promote self-advocacy by assisting participants to have their voices heard; their needs, goals, and objectives established as the focal point of recovery Assist participants in building social skills in the community that will enhance permanent housing acquisition and retention Serve as a link between participants and other needed services Schedule/provide guest transportation to/from appointments, meetings, and employment as required Facilitate Life Skills Classes on a weekly basis-develop topics and skills to be taught, practiced, and modeled throughout the housing search process, other housing related issues, and housing stability Develop meaningful relationships with landlords and property management companies to facilitate timely, accurate referrals for housing opportunities Maintains required level of security each shift Ensure that all supplies are properly stored ready to be used by the co-workers or guest Build “Trust”; be consistent, trustworthy, and honest Complete documentation and data entry tasks on assigned shifts without delay. Assist with seasonal/special Events as assigned Perform other tasks as assigned PHYSICAL REQUIREMENTS: Sit, walk, stand, bend, squat, climb, kneel, and twist on an intermittent or continuous basis Grasp, push, pull objects such as files, file cabinet drawers, and reach overhead Operate multi-line telephone Operate a desktop or laptop computer Lift up to 30 pounds regularly and 50 pounds occasionally Access and produce information from a computer Understand written information Sweep, clean, shovel snow, operate snow blower; perform janitorial tasks as needed Qualified individuals must be able to perform the essential duties of the position with or without accommodation. A qualified person with a disability may request a modification or adjustment to the job or work environment in order to meet the physical requirements of the position. The Salvation Army will attempt to satisfy requests as long as the accommodation needed is reasonable and no undue hardship would result. The Salvation Army is an Equal Opportunity Employer: Minorities/Women/Veterans/Disabled
    $33k-41k yearly est. 1d ago
  • WFS SSVF Case Manager

    Goodwill Industries of The Inland Northwest 4.0company rating

    Clinical case manager job in Spokane, WA

    Job Description Closes: 1/11/26 - Spokane, WA - Full-time/Hourly Wage: $25.00 p/h Employment Benefits: ************************************** NOTE: Please apply early, as this job posting is subject to removal before the deadline if sufficient number of qualified applications are received. Thank you. Summary: Provide Supportive Services to Veterans & their families in this grant funded program. Provide case management services to Veterans to develop & execute Individual Housing Plans that enhance housing security to eligible participants through direct & indirect service provision in Goodwill & partner agencies. Must have valid driver license with personal auto insurance as well as pass background & driver record check. Education &/or Experience: Bachelor's degree from four-year college or university; or one to two years related experience &/or training; or equivalent combination of education & experience. Essential Duties & Responsibilities include the following: Effectively assist participants to achieve & maintain housing stability by coordinating &/or providing supportive services. Ensure that participants receive the assistance needed to promote housing stability, including: consulting with participants to conduct needs assessment, working with participants to create individualized housing stability plans that include specific plans & specific goals, monitoring participants from the time of intake until they exit the program, & ensuring that participants obtain needed supportive services, re-evaluate participant eligibility, per program requirements. Interpret & explain information, such as eligibility requirements, application details, & program specific information. Determine the participant's household needs & priorities. Gather & record information about the participant's health, income, eligibility for public benefits, employment skills, background, family relationships & supports, & living situation in order to identify & coordinate those services that will be most effective & acceptable to the participant in improving housing stability. Coordinate activities & work collaboratively with department & contracted community agencies providing services under the SSVF program to ensure that Individual Housing Plans are achieved. Create & utilize informal community networks, as needed, to locate resources & make referrals as necessary in support of Individual Housing Plans. Participate in meetings, staffings, & other activities as directed to promote & review the effectiveness of Individual Housing Plans & overall case management efforts. Conduct other services & activities in concert with Department of Veterans Affairs, Supportive Services for Veterans Families program guide & at the direction of Program Manager. Establish & maintain good working relationships with participants, referral agencies, community partners, & all team members. Ensure all paperwork & related activities are entered, current, accurate, & in compliance in a timely manner. Seek new sources of revenue that will meet Goodwill's mission & align with strategic plan. Provide services in accordance with Goodwill policies, procedures, CARF standards, & principles of safety for personnel, participants & property. Maintain flexibility to work occasional evenings or weekend shifts. Make necessary notifications when required to law enforcement, supervisors & other appropriate individuals. Demonstrate respect & value all veterans, regardless of circumstances, behavior or needs. Work collaboratively with Workforce & Family Services to provide participant services. Follow all policies, procedures, & directives of Goodwill Industries of the Inland Northwest assuring safety of personnel or property. Properly wear & maintain all required Personal Protective Equipment (PPE). Maintain agency confidentiality. Violation of confidentiality is cause for immediate dismissal. Comply with all health, safety, & fire standards & all local, state, & federal regulations (WISHA & OSHA). Other duties as assigned. Job Posted by ApplicantPro
    $25 hourly 18d ago
  • Case Manager/QIDP

    Renewed Horizons

    Clinical case manager job in Hayden, ID

    📄 Case Manager (QIDP) 🕒 Schedule: Full-Time | Monday-Friday 📞 On-Call Rotation: Every 6 weeks 💲 Pay: Competitive, DOE _______________________________________________________________________________________ 🎯 Lead with Insight. Support with Precision. Renewed Horizons is seeking a qualified and detail-oriented Case Manager (QIDP) to join our person-centered team supporting adults with developmental disabilities. This is a dynamic leadership role that blends documentation, coordination, and advocacy - perfect for someone who thrives on organization, communication, and teamwork. As a Case Manager, you'll ensure quality care and services are being delivered by leading support planning, facilitating team communication, and working closely with families, providers, and support staff. _______________________________________________________________________________________ 🔍 What You'll Do: ✔ Coordinate and manage individualized care plans and services ✔ Maintain all required documentation with a strong attention to detail ✔ Lead interdisciplinary team meetings to ensure participants' needs are met ✔ Collaborate with family members, guardians, Targeted Service Coordinators, and staff ✔ Conduct observations and ensure all services align with participants' goals ✔ Assist in ongoing training, monitoring, and support for direct care teams ✔ Monitor compliance with regulations and reporting timelines _______________________________________________________________________________________ 🎓 What You'll Need: ✅ Must meet QIDP requirements (Qualified Intellectual Disabilities Professional) ✅ Bachelor's degree in a human services field (e.g., Psychology, Social Work, Education, or related) ✅ Minimum 2 years of experience working with individuals with developmental disabilities ✅ Excellent written and verbal communication skills ✅ Strong organization and time management ✅ Ability to work independently and collaborate across teams ✅ Proficiency in documentation, reporting, and compliance standards ✅ Valid driver's license and reliable transportation ✅ Must pass a background check _______________________________________________________________________________________ ✨ Why Join Renewed Horizons? 🩺 Healthcare benefits available 📚 Ongoing training and career development 💼 Leadership and autonomy in a mission-driven role 🤝 Supportive team atmosphere and open communication 📅 Predictable weekday schedule 📍 Local office in Hayden, Idaho with meaningful field engagement _______________________________________________________________________________________ 📬 How to Apply: 🌐 Online: *********************** 📞 Call us: ************ 📍 Visit us: 8252 N Wayne Drive, Hayden, Idaho 📄 If you're a dedicated professional ready to make a measurable difference in the lives of others - and support a team committed to compassionate, effective care - we'd love to hear from you!
    $29k-44k yearly est. 60d+ ago
  • Regional Field Case Manager I - Spokane

    CHPW

    Clinical case manager job in Spokane, WA

    This position is a hybrid of remote from home and field work. The candidate will need to reside in and travel throughout the Spokane region (Ferry, Stevens, Pend Oreille, Lincoln, Spokane and Adams counties). Who we are Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration. Our commitment is to: Strive to apply an equity lens to all our work. Reduce health disparities. Create an equitable work environment. About the Role This position works under the general direction of the Supervisor of Care Management and is responsible for the plan's regional field care management and coordination programs and processes. The Regional Field Case Manager will provide care management services for CHPW members with short term, long term, stable, unstable, and predictable course of illness. The Regional Field Case Manager resides within the assigned region to effectively coordinate care between members, providers and community resources. This role also provides care management services for CHPW members with highly complex medical/behavioral and social conditions where advocacy and coordination are required. This role represents CHPW in the community to provide education on care management programs and provide in-person support for members. The Regional Field Case Manager coordinates with internal and external partners to support members, providers and initiatives in the assigned region. To be successful in this role, you: Possess a Bachelor's degree in nursing or a master's degree in social work and/or a related behavior health field (required). Have a current, unrestricted license in the state of Washington as a registered nurse (RN) (required) OR Have a current, unrestricted license in the State of Washington as a Social Worker (LSWAA, LSWAIC) (required) OR Current, unrestricted license in the State of Washington as a Mental health Counselor (LMHC), Mental Health Professional (LMHP), or Marriage and Family Therapist (LMFT) (required) Have a minimum of one (1) year case management experience; home health or discharge planning experience; or a combination of education and experience which provides an equivalent background required OR Have a minimum of one (1) year in an acute care, facility-based medical or behavioral health experience and/or outpatient psychiatric and substance abuse disorder treatment experience, required; or equivalent combination of education and experience and/or working with children and families. Have experience with those who have disabilities and knowledge of Child and Families Services. Have a minimum three (3) years of clinical experience and/or outpatient setting (required). Have a valid state issued drivers' license. Preferred Have a case management certification. Are bilingual. Have experience in managed care (Medicaid/HCA). Have previous experience in using Care Management software applications. Have knowledge of, and experience with, community resources. Have experience in care management workflow systems. Essential functions and Roles and Responsibilities: Engages with members, providers and agencies in the assigned region to support field care management services. Provides face-to-face visits to members where telephonic care management is a barrier, to foster effective participation in the care management program. Identify and partner with emergency response services or other programs in a community that support members who are high utilizers of medical/behavioral health services.Field case management can include meeting members in acute care, emergency room, adult family home, Inpatient behavioral health facilities, shelters, community health centers, members home or member preferred location. Assesses, evaluates, plans, implements, and documents the care of members within the organizations' clinical database system in accordance with organizational policies and procedures. Implements the plan of care through direct member care, coordination, and delegation of the activities of the health care team. Promotes continuity of care by accurately and completely communicating to health care team the status of members for whom care is provided. Evaluates members' progress towards goals, identify potential barriers, assists members in navigating the healthcare system and expected outcomes in collaboration with member and the interdisciplinary care team. Works within the multi-interdisciplinary care team that collaborates with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes. Advocates on behalf of members and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions. Represents CHPW Care Management Department in the community to provide education on care management programs and collaborate with providers and community partners. Leads regional based projects as assigned Participates in external care conferences and other d/c planning activities that may be needed to prevent a readmission as needed. Participates in clinical case review with internal interdisciplinary team at Care Management Rounds. Employees are expected to report to work as scheduled, participate in all assigned meetings, and meet established performance and accountability standards. Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion. This position requires traveling on behalf of the Company and working in the field at least 50% of the time. It is essential that a current driver's license, proof of insurance and an acceptable driving record are maintained. Knowledge, Skills, and Abilities: Knowledge of regulatory and certification requirements and their impact on the organization such as CMS, HCA, HEDIS, CAHPS, and NCQA. Knowledge of and experience with community and other resources Analytical skills and the ability to interpret, evaluate and formulate action plans based upon data Organizational, time management, and project management skills Ability to handle multiple priorities Ability to multi-task and deal with complex assignments on a frequent basis Proficiency and experience with Microsoft Office products Written and verbal communication skills; able to communicate with and collaborate effectively with internal departments, physicians and allied health care providers Ability to work independently Perform all functions of the job with accuracy, attention to detail and within established timeframes. Ability to maintain confidentiality Note: If you think you do not qualify, please reconsider. Studies have shown that women and people of color are less likely to apply to jobs unless they feel they meet every qualification. However, everyone brings different strengths to the table for a job, and people can be successful in a role in a variety of ways. If you are excited about this job but your experience doesn't perfectly check every box in the , we encourage you to apply anyway. As part of our hiring process, the following criteria must be met: Complete and successfully pass a criminal background check Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant's criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees. Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency Vaccination requirement (CHPW offers a process for medical or religious exemptions) Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. Compensation and Benefits: The position is FLSA Exempt and is not eligible for overtime and has a 10% annual incentive target based on company, department, and individual performance goals. The base pay actually offered will take into account internal equity and also may vary depending on the candidate's job-related knowledge, skills, and experience among other factors. CHPW offers the following benefits for Full and Part-time employees and their dependents: Medical, Prescription, Dental, and Vision Telehealth app Flexible Spending Accounts, Health Savings Accounts Basic Life AD&D, Short and Long-Term Disability Voluntary Life, Critical Care, and Long-Term Care Insurance 401(k) Retirement and generous employer match Employee Assistance Program and Mental Fitness app Financial Coaching, Identity Theft Protection Time off including PTO accrual starting at 17 days per year 40 hours Community Service volunteer time 10 standard holidays, 2 floating holidays Compassion time off, jury duty Sensory/Physical/Mental Requirements: Sensory*: Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance. Physical*: Extended periods of sitting, computer use, talking, and possibly standing Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion Mental: Must have the ability to learn and prioritize multiple tasks within the scope and guidelines of the position and its applicable licensure requirements, many requiring extremely complex cognitive capabilities. Must be able to manage conflict, communicate effectively and meet time-sensitive deadlines. Work Environment: Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation. *Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. *The above is intended to describe the general content of and the requirements for satisfactory performance in this position. It is not to be construed as an exhaustive statement of the duties, responsibilities, or requirements of this position. Job descriptions may be updated or changed to reflect business needs.
    $32k-49k yearly est. 56d ago
  • Regional Field Case Manager I - Spokane

    Community Health Plan of Washington 4.3company rating

    Clinical case manager job in Spokane, WA

    This position is a hybrid of remote from home and field work. The candidate will need to reside in and travel throughout the Spokane region (Ferry, Stevens, Pend Oreille, Lincoln, Spokane and Adams counties). Who we are Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration. Our commitment is to: * Strive to apply an equity lens to all our work. * Reduce health disparities. * Create an equitable work environment. About the Role This position works under the general direction of the Supervisor of Care Management and is responsible for the plan's regional field care management and coordination programs and processes. The Regional Field Case Manager will provide care management services for CHPW members with short term, long term, stable, unstable, and predictable course of illness. The Regional Field Case Manager resides within the assigned region to effectively coordinate care between members, providers and community resources. This role also provides care management services for CHPW members with highly complex medical/behavioral and social conditions where advocacy and coordination are required. This role represents CHPW in the community to provide education on care management programs and provide in-person support for members. The Regional Field Case Manager coordinates with internal and external partners to support members, providers and initiatives in the assigned region. To be successful in this role, you: * Possess a Bachelor's degree in nursing or a master's degree in social work and/or a related behavior health field (required). * Have a current, unrestricted license in the state of Washington as a registered nurse (RN) (required) OR * Have a current, unrestricted license in the State of Washington as a Social Worker (LSWAA, LSWAIC) (required) OR * Current, unrestricted license in the State of Washington as a Mental health Counselor (LMHC), Mental Health Professional (LMHP), or Marriage and Family Therapist (LMFT) (required) * Have a minimum of one (1) year case management experience; home health or discharge planning experience; or a combination of education and experience which provides an equivalent background required OR * Have a minimum of one (1) year in an acute care, facility-based medical or behavioral health experience and/or outpatient psychiatric and substance abuse disorder treatment experience, required; or equivalent combination of education and experience and/or working with children and families. * Have experience with those who have disabilities and knowledge of Child and Families Services. * Have a minimum three (3) years of clinical experience and/or outpatient setting (required). * Have a valid state issued drivers' license. Preferred * Have a case management certification. * Are bilingual. * Have experience in managed care (Medicaid/HCA). * Have previous experience in using Care Management software applications. * Have knowledge of, and experience with, community resources. * Have experience in care management workflow systems. Essential functions and Roles and Responsibilities: * Engages with members, providers and agencies in the assigned region to support field care management services. * Provides face-to-face visits to members where telephonic care management is a barrier, to foster effective participation in the care management program. * Identify and partner with emergency response services or other programs in a community that support members who are high utilizers of medical/behavioral health services.Field case management can include meeting members in acute care, emergency room, adult family home, Inpatient behavioral health facilities, shelters, community health centers, members home or member preferred location. * Assesses, evaluates, plans, implements, and documents the care of members within the organizations' clinical database system in accordance with organizational policies and procedures. * Implements the plan of care through direct member care, coordination, and delegation of the activities of the health care team. Promotes continuity of care by accurately and completely communicating to health care team the status of members for whom care is provided. * Evaluates members' progress towards goals, identify potential barriers, assists members in navigating the healthcare system and expected outcomes in collaboration with member and the interdisciplinary care team. * Works within the multi-interdisciplinary care team that collaborates with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes. * Advocates on behalf of members and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions. * Represents CHPW Care Management Department in the community to provide education on care management programs and collaborate with providers and community partners. Leads regional based projects as assigned * Participates in external care conferences and other d/c planning activities that may be needed to prevent a readmission as needed. * Participates in clinical case review with internal interdisciplinary team at Care Management Rounds. * Employees are expected to report to work as scheduled, participate in all assigned meetings, and meet established performance and accountability standards. * Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion. * This position requires traveling on behalf of the Company and working in the field at least 50% of the time. It is essential that a current driver's license, proof of insurance and an acceptable driving record are maintained. Knowledge, Skills, and Abilities: * Knowledge of regulatory and certification requirements and their impact on the organization such as CMS, HCA, HEDIS, CAHPS, and NCQA. * Knowledge of and experience with community and other resources * Analytical skills and the ability to interpret, evaluate and formulate action plans based upon data * Organizational, time management, and project management skills * Ability to handle multiple priorities * Ability to multi-task and deal with complex assignments on a frequent basis * Proficiency and experience with Microsoft Office products * Written and verbal communication skills; able to communicate with and collaborate effectively with internal departments, physicians and allied health care providers * Ability to work independently * Perform all functions of the job with accuracy, attention to detail and within established timeframes. * Ability to maintain confidentiality Note: If you think you do not qualify, please reconsider. Studies have shown that women and people of color are less likely to apply to jobs unless they feel they meet every qualification. However, everyone brings different strengths to the table for a job, and people can be successful in a role in a variety of ways. If you are excited about this job but your experience doesn't perfectly check every box in the , we encourage you to apply anyway. As part of our hiring process, the following criteria must be met: * Complete and successfully pass a criminal background check Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant's criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees. * Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency * Vaccination requirement (CHPW offers a process for medical or religious exemptions) * Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. Compensation and Benefits: The position is FLSA Exempt and is not eligible for overtime and has a 10% annual incentive target based on company, department, and individual performance goals. The base pay actually offered will take into account internal equity and also may vary depending on the candidate's job-related knowledge, skills, and experience among other factors. CHPW offers the following benefits for Full and Part-time employees and their dependents: * Medical, Prescription, Dental, and Vision * Telehealth app * Flexible Spending Accounts, Health Savings Accounts * Basic Life AD&D, Short and Long-Term Disability * Voluntary Life, Critical Care, and Long-Term Care Insurance * 401(k) Retirement and generous employer match * Employee Assistance Program and Mental Fitness app * Financial Coaching, Identity Theft Protection * Time off including PTO accrual starting at 17 days per year * 40 hours Community Service volunteer time * 10 standard holidays, 2 floating holidays * Compassion time off, jury duty Sensory/Physical/Mental Requirements: Sensory*: * Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance. Physical*: * Extended periods of sitting, computer use, talking, and possibly standing * Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion Mental: * Must have the ability to learn and prioritize multiple tasks within the scope and guidelines of the position and its applicable licensure requirements, many requiring extremely complex cognitive capabilities. Must be able to manage conflict, communicate effectively and meet time-sensitive deadlines. Work Environment: Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation. * Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. * The above is intended to describe the general content of and the requirements for satisfactory performance in this position. It is not to be construed as an exhaustive statement of the duties, responsibilities, or requirements of this position. Job descriptions may be updated or changed to reflect business needs.
    $43k-54k yearly est. 33d ago
  • Housing Case Manager Lead - Veterans

    Volunteers of America Eastern Wa Northern Id

    Clinical case manager job in Spokane, WA

    Description Grant Per Diem (GPD) Lead Case Manager Volunteers of America Eastern Washington & Northern Idaho (VOA Spokane) Seeing People First - Empowering All to Thrive About the Role The GPD Lead Case Manager supports Veterans transitioning from homelessness to stable housing within the Grant Per Diem program. This role ensures consistent, high-quality service delivery by completing admissions and discharges, reviewing referrals, coordinating with VA partners, maintaining strong documentation standards, and supporting case managers with daily program operations. This is a lead role without supervisory authority. The Lead ensures processes are followed, concerns are escalated appropriately, and program standards remain consistent across the team. Schedules may include 5x8 or 4x10 shifts, with weekend coverage as needed. What You'll Do • Manage a caseload of Veterans working toward stable housing. • Complete admissions and discharges and ensure timely, accurate documentation. • Review VA referrals, verify eligibility, check case history, and respond within required timeframes. • Conduct assessments and develop individualized service plans addressing housing, benefits, employment, education, and stabilization needs. • Meet regularly with participants to track progress and update goals. • Support Veterans in navigating housing, healthcare, benefits, courts, and other complex systems. • Apply trauma-informed, restorative, and strengths-based approaches to conflict resolution. • Serve as a primary liaison with VA HCHV staff and SSVF partners for referrals, coordination, and staffing. • Prepare for quarterly VA inspections, including documentation, environmental reviews, and compliance checks. • Assist with weekly, monthly, and annual reporting, including bed counts. • Maintain program supplies and complete food and supply purchases with approval. • Facilitate bi-weekly house meetings, including agenda planning and food preparation. • Conduct weekly unit inspections and maintain office/community spaces according to cleaning schedules. • Complete incident reports and escalate safety concerns to appropriate leadership. • Support case managers by helping ensure consistent processes, documentation expectations, and workflows. Requirements What You Bring • High school diploma/GED required; bachelor's degree preferred. Veteran status may substitute for a degree. • Experience supporting individuals experiencing homelessness, behavioral health challenges, substance use, trauma, or legal-system involvement. • Strong communication skills and the ability to build rapport with diverse participants. • Ability to multitask in a high-volume, fast-paced environment. • Strong problem-solving, assessment, and documentation skills. • Knowledge of housing systems, VA supports, benefits programs, or community services preferred. • Proficiency with Microsoft Office, Google Suite, and case management software. Requirements • Eligible for an Agency Affiliated Counselor (AAC) credential and able to apply within 30 days of hire. • CPR/First Aid/BBP certification within 6 months (agency paid). • Valid driver's license, insurance, and reliable transportation. • Ability to pass a comprehensive criminal background check and driving record review. Work Environment • Mix of office work, meetings with participants, and community-based case management. • Regular walking, stair climbing, and lifting up to 25 pounds (occasionally up to 50). • Exposure to varied indoor and outdoor environments, including less-than-ideal conditions or participants in distress. Why Join VOA Spokane? • 100% employer-paid medical, dental, and vision for full-time staff • Mission-driven culture focused on dignity, stability, and empowerment • Supportive leadership, growth pathways, and agency-paid credentialing • Meaningful work directly impacting the lives of Veterans in transition Salary Description $26.00 - $27.00
    $38k-45k yearly est. 17d ago
  • Housing Case Manager Lead - Veterans

    Mac's List

    Clinical case manager job in Spokane, WA

    Grant Per Diem (GPD) Lead Case Manager Volunteers of America Eastern Washington & Northern Idaho (VOA Spokane) Seeing People First - Empowering All to Thrive About the Role The GPD Lead Case Manager supports Veterans transitioning from homelessness to stable housing within the Grant Per Diem program. This role ensures consistent, high-quality service delivery by completing admissions and discharges, reviewing referrals, coordinating with VA partners, maintaining strong documentation standards, and supporting case managers with daily program operations. This is a lead role without supervisory authority. The Lead ensures processes are followed, concerns are escalated appropriately, and program standards remain consistent across the team. Schedules may include 5x8 or 4x10 shifts, with weekend coverage as needed. What You'll Do * Manage a caseload of Veterans working toward stable housing. * Complete admissions and discharges and ensure timely, accurate documentation. * Review VA referrals, verify eligibility, check case history, and respond within required timeframes. * Conduct assessments and develop individualized service plans addressing housing, benefits, employment, education, and stabilization needs. * Meet regularly with participants to track progress and update goals. * Support Veterans in navigating housing, healthcare, benefits, courts, and other complex systems. * Apply trauma-informed, restorative, and strengths-based approaches to conflict resolution. * Serve as a primary liaison with VA HCHV staff and SSVF partners for referrals, coordination, and staffing. * Prepare for quarterly VA inspections, including documentation, environmental reviews, and compliance checks. * Assist with weekly, monthly, and annual reporting, including bed counts. * Maintain program supplies and complete food and supply purchases with approval. * Facilitate bi-weekly house meetings, including agenda planning and food preparation. * Conduct weekly unit inspections and maintain office/community spaces according to cleaning schedules. * Complete incident reports and escalate safety concerns to appropriate leadership. * Support case managers by helping ensure consistent processes, documentation expectations, and workflows. Requirements What You Bring * High school diploma/GED required; bachelor's degree preferred. Veteran status may substitute for a degree. * Experience supporting individuals experiencing homelessness, behavioral health challenges, substance use, trauma, or legal-system involvement. * Strong communication skills and the ability to build rapport with diverse participants. * Ability to multitask in a high-volume, fast-paced environment. * Strong problem-solving, assessment, and documentation skills. * Knowledge of housing systems, VA supports, benefits programs, or community services preferred. * Proficiency with Microsoft Office, Google Suite, and case management software. Requirements * Eligible for an Agency Affiliated Counselor (AAC) credential and able to apply within 30 days of hire. * CPR/First Aid/BBP certification within 6 months (agency paid). * Valid driver's license, insurance, and reliable transportation. * Ability to pass a comprehensive criminal background check and driving record review. Work Environment * Mix of office work, meetings with participants, and community-based case management. * Regular walking, stair climbing, and lifting up to 25 pounds (occasionally up to 50). * Exposure to varied indoor and outdoor environments, including less-than-ideal conditions or participants in distress. Why Join VOA Spokane? * 100% employer-paid medical, dental, and vision for full-time staff * Mission-driven culture focused on dignity, stability, and empowerment * Supportive leadership, growth pathways, and agency-paid credentialing * Meaningful work directly impacting the lives of Veterans in transition Salary Description $26.00 - $27.00 Salary26.00 - 27.00 Hour Listing Type Jobs Categories Management Position Type Full Time Salary Min 26.00 Salary Max 27.00 Salary Type /hr.
    $38k-45k yearly est. 12d ago
  • Street Outreach Clinician / Therapist |Full-Time|

    Heritage Health 3.9company rating

    Clinical case manager job in Coeur dAlene, ID

    Heritage Health is seeking a full-time (1.0 FTE) Clinician/Therapist to join our Street Medicine team in Coeur d'Alene, Idaho. We prioritize work-life balance and offer a supportive environment to ensure our team members thrive both professionally and personally. $3,000 Sign-On Bonus Why You Should Join our Dynamic Healthcare Team: Passionate Purpose: We're committed to enhancing lives, every day. Unmatched Support: We are committed to a fun and supportive team environment. Balanced Lifestyle: No weekends or holidays, ensuring a healthy work-life balance. Collaborative Care: Work with a dedicated team to provide the best patient outcomes in the right settings. Exceptional Rewards: Competitive pay, and benefits Benefits: Health Insurance: 100% employer-paid employee coverage for medical, dental, and vision plans for full-time employees. Life Insurance: Employer-paid for 1x annual salary (optional coverage available for additional cost). Disability Insurance: Short-term disability insurance based on age & salary. 100% employer-paid long-term disability insurance. Retirement: 403 (b) plan: Heritage Health matches up to 4% of employee contributions. Paid Time Off Benefits: 120 hours Paid Time Off (PTO) in your first year, 56 hours Extended Illness Bank (EIB) in your first year, 8 paid holidays for full-time employees, amounts are pro-rated for part-time employees who are .5 FTE or higher. Employee Assistance Program (EAP): Enjoy free telehealth visits for healthcare, counseling, and health and wellness coaching for all employees and their immediate household members. Summary: The Street Medicine Therapist is responsible for providing confidential counseling, education and support to individuals, families and the community and for promoting healthy lifestyles and healthy choices. Requirements LPC or LMSW License. Working knowledge of administrative procedure of a Federally funded community health center; computer skills necessary to maintain client charts and communication within the organization; excellent communication skills. Must be able to pass an Idaho Department of Health and Welfare Criminal History Unit enhanced background check. Preferred Qualifications: Ability to meet Idaho code for Qualified Substance Use Disorder Professional. Personal lived experience with homelessness (self, family, friends, or in professional settings). Experience working with vulnerable clients in crisis. Experience working with inter-disciplinary teams. Experience developing curriculum and/or running dynamic psychoeducation groups focused on addressing the needs of homeless populations. Experience developing comprehensive therapeutic programs that utilize interdisciplinary teams approach. Experience developing stakeholder engagement and developing working teams from a broad range of service providers. Knowledge, Skills, and Abilities Required: Knowledge of industry standards and licensure rules and regulations. Participate in reciprocal feedback from counselors and clients. Previous experience in counseling. Adhere to code of ethics for licensed discipline. Knowledge of community resources and networking skills. Computer skills necessary to maintain client charts and communication within the organization Excellent communication skills. Essential Functions: Counsel clients or patients, individually or in group sessions, to assist in overcoming dependencies, adjusting to life, or making changes. Complete and maintain accurate records or reports regarding the patients' histories and progress, services provided, or other required information. Develop client treatment plans based on research, clinical experience, and client histories. Coordinate counseling efforts with mental health professionals or other health professionals, such as doctors, nurses, or social workers. Interview clients, review records, and confer with other professionals to evaluate individuals' mental and physical condition and to determine their suitability for participation in a specific program. Review and evaluate clients' progress in relation to measurable goals described in treatment and care plans. Provide clients or family members with information about addiction issues and about available services or programs, making appropriate referrals when necessary. Coordinate activities with courts, probation officers, community services, or other post-treatment agencies. Willingness to attend and participate in off-site meetings and/or seminars. Complete assessments. Regular and predictable attendance is an essential function of this position. Provide a wide range of social work services, i.e., direct counseling services, resource management, etc. in accordance with departmental guidelines. Knowledge and use of evidence-based best practice therapeutic models. Role modeling, organizational, communication and guest-relation skills. Other duties as assigned. Salary Description $62,022.48 - $97,864.83
    $62k-97.9k yearly 60d+ ago
  • Care Review Clinician II

    Integrated Resources 4.5company rating

    Clinical case manager job in Spokane, WA

    Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Job Description Title: Medical Claims Review Nurse Duration: 3 months (Temp to Hire) Location: Spokane, WA Responsibilities: · Non-exempt employee, 40 hours per week. Hours of operation 6 am - 5 pm. The manager is open for the employee to pick their start time as long as they know they must complete and 8 hour shift. They can choose. · This not remote, in office. · Production Guidelines after training- manager does 100% review of case on the first 2 months, so they receive feedback and then after that, they are audited monthly on a percentage of their caseloads and given feedback on the audited cases. · Managers are looking for candidates with clinical experience from a hospital (Preferred) · Min. 2- 3 years clinical nursing experience · 1 year of utilization review or medical claim review · RN License Required · Preferred Experience in one of more of the following areas critical care, emergency medicine, surgical, paediatrics, advanced practice nursing, and billing and coding experience · Great organizational skills · Critical thinkers and the ability to make decisions using clinical background/knowledge · Able to work independently · Able to collaborate and work with peers to make decisions · Knowledge of state and federal regulations · In-depth Knowledge of ICD-9, CPT, and HCPTS · Great Verbal and Written Communication Skills because they will be interacting with Medical Directors. · Interviews: Phone screen and if it goes well then an in person interview Knowledge/Skills/Abilities: • Demonstrated ability to communicate, problem solve, and work effectively with people. • Excellent organizational skill with the ability to manage multiple priorities. • Work independently and handle multiple projects simultaneously. • Knowledge of applicable state, and federal regulations. • In depth knowledge of Interqual and other references for length of stay and medical necessity determinations. • Experience with NCQA. • Ability to take initiative and see tasks to completion. • Computer Literate (Microsoft Office Products). • Excellent verbal and written communication skills. • Ability to abide by policies. • Ability to maintain attendance to support required quality and quantity of work. • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). • Skilled at establishing and maintaining positive and effective work relationships with co-workers, clients, members, providers and customers. Required Experience: • Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management. • Required Licensure/Certification: Active, unrestricted State. Additional Information Kind Regards Sumit Agarwal 732-902-2125
    $74k-104k yearly est. 60d+ ago
  • EAP On-site Clinician - Full-time (Spokane, Washington)

    Acentra Health

    Clinical case manager job in Spokane, WA

    Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Acentra seeks an Employee Assistance Program (EAP) On-site Clinician - Full-time - in Spokane, Washington) to join our growing team. Job Summary: As an Employee Assistance Program (EAP) Clinician at Acentra Health, the licensed clinician will provide a full range of EAP services for employees, managers, and the employer organization for a large government agency. Work schedule: 40 hours/week. Must be willing to occasionally travel to make site visits throughout the state, and hours/location are subject to change based on client needs. Job Responsibilities: * Consistently provide exceptional and proactive services as a licensed clinician, ensuring smooth integration with Acentra Health operations and accounts. * Provide direct counseling, critical incident response services, training or psychoeducational presentations, and outreach services that create awareness of EAP services. * Make referrals to treatment services where appropriate, ensuring a satisfactory client experience transitioning from EAP services to treatment services. * Refer to community resources to support clients' well-being and mental health. * Comply with all Clinical and Professional protocols, processes, and Acentra Health policies. * Understand the scope of EAP services and as needed, communicate that scope to external parties, including clients, managers, and other support staff. * Consult with Acentra Health supervisors concerning clinical case staffing and high-risk cases. * Maintain and manage a caseload of direct service counseling clients, maintaining case records in accordance with Acentra Health policies and practices. * Create and manage productive and positive working relationships with local points of contact. * Display excellent teamwork, communication, and collaboration with the account manager and other Acentra Health staff. * Work in collaboration with other internal and external stakeholders, always displaying professionalism. * Using a consultative approach, establish effective relationships with our clients and proactively collaborate on opportunities for product enhancement and optimization services to meet the client's specific needs. * Exhibit excellent interpersonal and problem-solving skills to retain and service our clients and the organization. * Maintains the security of areas, materials, and private information. This includes physical and virtual storage and filing. * Maintain a professional demeanor with customers and co-workers to represent Acentra Health's values and standards. * Perform daily duties and undertake and complete related projects in the area of expertise with minimal supervision. * Additional related projects/tasks/duties as assigned by the position's manager. * Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules. Qualifications Required Qualifications: * An active, unrestricted Independent License in the behavioral health field issued by the Washington State Department of Health (DOH): * Mental Health Counselors, Marriage and Family Therapists, and Social Workers Advisory Committee: * LMHC - Licensed Mental Health Counselor * LMFT - Licensed Marriage and Family Therapist * LICSW - Licensed Independent Clinical Social Worker * Washington State Examining Board of Psychology: * LP - Licensed Psychologist * Master's or Doctoral degree in Social Work, Counseling, Marriage and Family Therapy, or a related field. * 2+ years of professional experience in the EAP/mental health/substance abuse/behavioral health field. * Ability to pass a federal security clearance for a non-sensitive/high-risk public trust position. * Includes fingerprinting and a background investigation covering a seven-year investigative scope, and a drug screening. Preferred Qualifications: * Experience in facilitating training with Managers, Leaders, and employees. * Experience working with law enforcement, the military, or the veteran population. * Experience in facilitating critical incident responses. #LI-SD1 Why us? We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. Thank You! We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search! ~ The Acentra Health Talent Acquisition Team Benefits Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Visit us at Acentra Health EEO AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Compensation The pay range for this position is listed below. "Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level." Pay Range USD $82,600.00 - USD $95,000.00 /Yr.
    $82.6k-95k yearly 33d ago
  • Care Review Clinician

    Healthcare Support Staffing

    Clinical case manager job in Spokane, WA

    HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description • Evaluates medical records and/or medical notes providing clinical expertise on coding accuracy. • Reviews for provider reconsideration requests related to claim edits and validation outcomes. • Utilizes established criteria for review of complex medical claims and refers to Chief Medical Officer or Medical Director for determinations when criteria are not met • Acting as a clinical resource, provides clinical review of claims to determine coding and billing accuracy and medical appropriateness of various types of provider claims. • Reviews claims for correct billing and coding using Medicare Provider Manual guidelines. Documents clinical review summaries, bill audit findings and audit details in the data base. • Identifies and reports quality of care issues to the Quality Management Department. • Reports suspected member or provider fraud per Molina Healthcare Policy. • Identifies and refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. • Participates in the development and implementation of proactive approaches to improve and standardize overall retrospective claims review. Qualifications Candidate will provide clinical expertise in the application of medical and reimbursement policies within the claim adjudication process through claim review, medical record review and research. To provide expert knowledge in CMS, NCCI, AMA and other nationally published guidelines for correct coding and billing accuracy. • Minimum 2-4 years of clinical practice. • Minimum 1 year utilization review or medical claim review experience • Active, unrestricted state nursing license in good standing • Preferred Experience in one of more of the following areas critical care, emergency medicine, surgical, pediatrics, advanced practice nursing, and billing and coding experience • Great organizational skills • Critical thinkers and the ability to make decisions using clinical background/knowledge • Able to work independently • Able to collaborate and work with peers to make decisions • Knowledge of state and federal regulations • In-depth Knowledge of ICD-9, CPT, and HCPTS • Great Verbal and Written Communication Skills because they will be interacting with Medical Directors Additional Information If you are interested in applying to this position, please contact Brianne Salazar at (321)710-4799 and click the Green I'm Interested Button to email your resume.
    $53k-88k yearly est. 3h ago
  • Advanced Vocational English Case Manager (Part-time)

    World Relief 3.9company rating

    Clinical case manager job in Spokane, WA

    Job DescriptionAre you a person of compassion? An advocate for justice? Someone who stands up for the rights of the vulnerable and speaks out for the marginalized, the exploited and the forgotten? Do you believe in our calling as Christians to welcome the least of these and love our neighbor? If you answered ‘yes', to any of the above, World Relief, and millions of people around the world need you. At this pivotal moment in time, we are rapidly expanding and growing our team to meet the increasing needs of our world. We are looking for people who want to use their gifts and talents to make a real and tangible difference in our world and the lives of the suffering. If you're looking for a purpose-driven career in which you can grow your talents, while also standing up for the rights of the vulnerable, we want you to join us today. ORGANIZATION SUMMARYWorld Relief is a global Christian humanitarian organization whose mission is to boldly engage the world's greatest crises in partnership with the church. The organization was founded in the aftermath of World War II to respond to the urgent humanitarian needs of war-torn Europe. Since then, for 80 years, across 100 countries, World Relief has partnered with local churches and communities to build a world where families thrive and communities flourish. Today, organizational programming focuses on humanitarian and disaster response, community strengthening and resilience, and refugee & immigrant services and advocacy. This position is reliant upon funding and may be subject to modification or termination based on resource availability. POSITION SUMMARY:World Relief seeks an Advanced Vocational English Case Manager to support and empower newcomers as they work toward long-term career goals through providing Advanced Vocational English tutoring and coaching individuals and small groups. This part-time position is for 30 hours per week.ROLE & RESPONSIBILITIES: Address the vocational English needs of program participants and coordinate tutoring and coaching to meet these needs. Attend regular screenings and enrollments with other Career Pathways staff, to review and create new participant career plans. Coordinate Advanced Vocational English small groups tailored to the current needs of program participants. Identify, utilize and tailor advanced vocational English curriculum to use in small group tutoring. Prepare and distribute learning materials and supportive supplies to each client as needed/requested. Supervise interns and/or volunteers for tutoring and small group support as needed/available. Develop and deliver digital literacy coaching as needed. Manage computer loaner programs. Create assessments to evaluate readiness for a variety of educational and vocational opportunities. Be familiar with program guidelines and requirements. Careful tracking, record keeping and reporting in multiple database systems. Participate in required department and all-staff meetings. Other duties as assigned. JOB REQUIREMENTS: Mature and personal Christian faith Committed to the mission, vision, and values of World Relief Desire to serve and empower the Church to impact vulnerable communities Able to affirm and/or acknowledge World Reliefs Core Beliefs, Statement of Faith, Christian Identity and National Association of Evangelicals' For the Health of The Nation document Experience working cross culturally and non-native English speakers Bachelor's degree or higher, preferably in TESL/TESOL or a similar content area Valid driver's license, access to reliable vehicle and clean driving record PREFERRED QUALIFICATIONS: Excellent communication skills, both orally and in writing 1-year minimum experience in case management and group facilitation, including over virtual platforms Ability to complete tasks independently, thoroughly, and on time Flexible and adaptable to needs of students and changing program realities Ability to communicate well and work closely with a team Ability to use Windows and Microsoft software (including Word, Outlook, Teams, and PowerPoint), and Zoom Working knowledge of phone and laptop functionality World Relief offers a competitive benefits package and employee discount program for full-time, Regular, and part-time (25+ hours per week) employees World Relief is honored to be recognized with the Gold-level Cigna Healthy Workforce Designation for exceeding the core components of our well-being program including leadership and culture, program foundations and execution, and whole person health. ***Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. We are proud to be an EEO/AA employer M/F/D/V. We maintain a drug-free workplace and perform pre-employment substance abuse testing. For World Relief staff, strong commitment to the mission, vision, and values of World Relief is essential, and Christian faith is a prerequisite for employment, based upon United States federal guidelines provided in Title VII of the Civil Rights Act of 1964.
    $48k-55k yearly est. 15d ago
  • WFS SSVF Case Manager - Spokane, WA - Full-time/Hourly

    Goodwill Industries of The Inland Northwest 4.0company rating

    Clinical case manager job in Spokane, WA

    Closes: 1/11/26 - Spokane, WA - Full-time/Hourly Wage: $25.00 p/h Employment Benefits: ************************************** NOTE: Please apply early, as this job posting is subject to removal before the deadline if sufficient number of qualified applications are received. Thank you. Summary: Provide Supportive Services to Veterans & their families in this grant funded program. Provide case management services to Veterans to develop & execute Individual Housing Plans that enhance housing security to eligible participants through direct & indirect service provision in Goodwill & partner agencies. Must have valid driver license with personal auto insurance as well as pass background & driver record check. Education &/or Experience: Bachelor's degree from four-year college or university; or one to two years related experience &/or training; or equivalent combination of education & experience. Essential Duties & Responsibilities include the following: * Effectively assist participants to achieve & maintain housing stability by coordinating &/or providing supportive services. * Ensure that participants receive the assistance needed to promote housing stability, including: consulting with participants to conduct needs assessment, working with participants to create individualized housing stability plans that include specific plans & specific goals, monitoring participants from the time of intake until they exit the program, & ensuring that participants obtain needed supportive services, re-evaluate participant eligibility, per program requirements. * Interpret & explain information, such as eligibility requirements, application details, & program specific information. * Determine the participant's household needs & priorities. Gather & record information about the participant's health, income, eligibility for public benefits, employment skills, background, family relationships & supports, & living situation in order to identify & coordinate those services that will be most effective & acceptable to the participant in improving housing stability. * Coordinate activities & work collaboratively with department & contracted community agencies providing services under the SSVF program to ensure that Individual Housing Plans are achieved. * Create & utilize informal community networks, as needed, to locate resources & make referrals as necessary in support of Individual Housing Plans. * Participate in meetings, staffings, & other activities as directed to promote & review the effectiveness of Individual Housing Plans & overall case management efforts. * Conduct other services & activities in concert with Department of Veterans Affairs, Supportive Services for Veterans Families program guide & at the direction of Program Manager. * Establish & maintain good working relationships with participants, referral agencies, community partners, & all team members. * Ensure all paperwork & related activities are entered, current, accurate, & in compliance in a timely manner. * Seek new sources of revenue that will meet Goodwill's mission & align with strategic plan. * Provide services in accordance with Goodwill policies, procedures, CARF standards, & principles of safety for personnel, participants & property. * Maintain flexibility to work occasional evenings or weekend shifts. * Make necessary notifications when required to law enforcement, supervisors & other appropriate individuals. * Demonstrate respect & value all veterans, regardless of circumstances, behavior or needs. * Work collaboratively with Workforce & Family Services to provide participant services. * Follow all policies, procedures, & directives of Goodwill Industries of the Inland Northwest assuring safety of personnel or property. * Properly wear & maintain all required Personal Protective Equipment (PPE). * Maintain agency confidentiality. Violation of confidentiality is cause for immediate dismissal. * Comply with all health, safety, & fire standards & all local, state, & federal regulations (WISHA & OSHA). * Other duties as assigned.
    $25 hourly 19d ago
  • Regional Field Case Manager I - Spokane

    Community Health Plan of Washington 4.3company rating

    Clinical case manager job in Spokane, WA

    This position is a hybrid of remote from home and field work. The candidate will need to reside in and travel throughout the Spokane region (Ferry, Stevens, Pend Oreille, Lincoln, Spokane and Adams counties). Who we are Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration. Our commitment is to: Strive to apply an equity lens to all our work. Reduce health disparities. Create an equitable work environment. About the Role This position works under the general direction of the Supervisor of Care Management and is responsible for the plan's regional field care management and coordination programs and processes. The Regional Field Case Manager will provide care management services for CHPW members with short term, long term, stable, unstable, and predictable course of illness. The Regional Field Case Manager resides within the assigned region to effectively coordinate care between members, providers and community resources. This role also provides care management services for CHPW members with highly complex medical/behavioral and social conditions where advocacy and coordination are required. This role represents CHPW in the community to provide education on care management programs and provide in-person support for members. The Regional Field Case Manager coordinates with internal and external partners to support members, providers and initiatives in the assigned region. To be successful in this role, you: Possess a Bachelor's degree in nursing or a master's degree in social work and/or a related behavior health field (required). Have a current, unrestricted license in the state of Washington as a registered nurse (RN) (required) OR Have a current, unrestricted license in the State of Washington as a Social Worker (LSWAA, LSWAIC) (required) OR Current, unrestricted license in the State of Washington as a Mental health Counselor (LMHC), Mental Health Professional (LMHP), or Marriage and Family Therapist (LMFT) (required) Have a minimum of one (1) year case management experience; home health or discharge planning experience; or a combination of education and experience which provides an equivalent background required OR Have a minimum of one (1) year in an acute care, facility-based medical or behavioral health experience and/or outpatient psychiatric and substance abuse disorder treatment experience, required; or equivalent combination of education and experience and/or working with children and families. Have experience with those who have disabilities and knowledge of Child and Families Services. Have a minimum three (3) years of clinical experience and/or outpatient setting (required). Have a valid state issued drivers' license. Preferred Have a case management certification. Are bilingual. Have experience in managed care (Medicaid/HCA). Have previous experience in using Care Management software applications. Have knowledge of, and experience with, community resources. Have experience in care management workflow systems. Essential functions and Roles and Responsibilities: Engages with members, providers and agencies in the assigned region to support field care management services. Provides face-to-face visits to members where telephonic care management is a barrier, to foster effective participation in the care management program. Identify and partner with emergency response services or other programs in a community that support members who are high utilizers of medical/behavioral health services.Field case management can include meeting members in acute care, emergency room, adult family home, Inpatient behavioral health facilities, shelters, community health centers, members home or member preferred location. Assesses, evaluates, plans, implements, and documents the care of members within the organizations' clinical database system in accordance with organizational policies and procedures. Implements the plan of care through direct member care, coordination, and delegation of the activities of the health care team. Promotes continuity of care by accurately and completely communicating to health care team the status of members for whom care is provided. Evaluates members' progress towards goals, identify potential barriers, assists members in navigating the healthcare system and expected outcomes in collaboration with member and the interdisciplinary care team. Works within the multi-interdisciplinary care team that collaborates with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes. Advocates on behalf of members and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions. Represents CHPW Care Management Department in the community to provide education on care management programs and collaborate with providers and community partners. Leads regional based projects as assigned Participates in external care conferences and other d/c planning activities that may be needed to prevent a readmission as needed. Participates in clinical case review with internal interdisciplinary team at Care Management Rounds. Employees are expected to report to work as scheduled, participate in all assigned meetings, and meet established performance and accountability standards. Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion. This position requires traveling on behalf of the Company and working in the field at least 50% of the time. It is essential that a current driver's license, proof of insurance and an acceptable driving record are maintained. Knowledge, Skills, and Abilities: Knowledge of regulatory and certification requirements and their impact on the organization such as CMS, HCA, HEDIS, CAHPS, and NCQA. Knowledge of and experience with community and other resources Analytical skills and the ability to interpret, evaluate and formulate action plans based upon data Organizational, time management, and project management skills Ability to handle multiple priorities Ability to multi-task and deal with complex assignments on a frequent basis Proficiency and experience with Microsoft Office products Written and verbal communication skills; able to communicate with and collaborate effectively with internal departments, physicians and allied health care providers Ability to work independently Perform all functions of the job with accuracy, attention to detail and within established timeframes. Ability to maintain confidentiality Note: If you think you do not qualify, please reconsider. Studies have shown that women and people of color are less likely to apply to jobs unless they feel they meet every qualification. However, everyone brings different strengths to the table for a job, and people can be successful in a role in a variety of ways. If you are excited about this job but your experience doesn't perfectly check every box in the , we encourage you to apply anyway. As part of our hiring process, the following criteria must be met: Complete and successfully pass a criminal background check Criminal History: includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant's criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and/employees. Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency Vaccination requirement (CHPW offers a process for medical or religious exemptions) Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. Compensation and Benefits: The position is FLSA Exempt and is not eligible for overtime and has a 10% annual incentive target based on company, department, and individual performance goals. The base pay actually offered will take into account internal equity and also may vary depending on the candidate's job-related knowledge, skills, and experience among other factors. CHPW offers the following benefits for Full and Part-time employees and their dependents: Medical, Prescription, Dental, and Vision Telehealth app Flexible Spending Accounts, Health Savings Accounts Basic Life AD&D, Short and Long-Term Disability Voluntary Life, Critical Care, and Long-Term Care Insurance 401(k) Retirement and generous employer match Employee Assistance Program and Mental Fitness app Financial Coaching, Identity Theft Protection Time off including PTO accrual starting at 17 days per year 40 hours Community Service volunteer time 10 standard holidays, 2 floating holidays Compassion time off, jury duty Sensory/Physical/Mental Requirements: Sensory*: Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance. Physical*: Extended periods of sitting, computer use, talking, and possibly standing Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion Mental: Must have the ability to learn and prioritize multiple tasks within the scope and guidelines of the position and its applicable licensure requirements, many requiring extremely complex cognitive capabilities. Must be able to manage conflict, communicate effectively and meet time-sensitive deadlines. Work Environment: Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation. *Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation. *The above is intended to describe the general content of and the requirements for satisfactory performance in this position. It is not to be construed as an exhaustive statement of the duties, responsibilities, or requirements of this position. Job descriptions may be updated or changed to reflect business needs.
    $43k-54k yearly est. 29d ago
  • ACT Treatment Team Clinician |Full-Time|

    Heritage Health 3.9company rating

    Clinical case manager job in Coeur dAlene, ID

    Heritage Health is seeking a full-time (1.0 FTE) compassionate and dedicated Clinician to join our Assertive Community Treatment (ACT) team in Coeur d'Alene, Idaho. We prioritize work-life balance and offer a supportive environment to ensure our team members thrive both professionally and personally. Why You Should Join our Dynamic Healthcare Team: Passionate Purpose: We're committed to enhancing lives, every day. Unmatched Support: We are committed to a fun and supportive team environment. Balanced Lifestyle: No weekends or holidays, ensuring a healthy work-life balance. Collaborative Care: Work with a dedicated team to provide the best patient outcomes in the right settings. Exceptional Rewards: Competitive pay, and benefits Benefits: Health Insurance: 100% employer-paid employee coverage for medical, dental, and vision plans for full-time employees. Life Insurance: Employer-paid for 1x annual salary (optional coverage available for additional cost). Disability Insurance: Short-term disability insurance based on age & salary. 100% employer-paid long-term disability insurance. Retirement: 403 (b) plan: Heritage Health matches up to 4% of employee contributions. Paid Time Off Benefits: 120 hours Paid Time Off (PTO) in your first year, 56 hours Extended Illness Bank (EIB) in your first year, 8 paid holidays for full-time employees, amounts are pro-rated for part-time employees who are .5 FTE or higher. Employee Assistance Program (EAP): Enjoy free telehealth visits for healthcare, counseling, and health and wellness coaching for all employees and their immediate household members. In this role, you will build and sustain therapeutic relationships with clients in diverse settings, including hospitals, homes, and community environments. You'll collaborate with clients to develop and adapt individualized treatment plans that reflect their goals and evolving needs, while advocating for their rights and ensuring their voices remain central in care decisions. You'll coordinate with community partners to integrate holistic supports, provide education and guidance to families and caregivers, deliver individual supportive therapy, respond to crises, and lead the Individual Treatment Team (ITT) by offering clinical oversight to ensure cohesive, client-centered service delivery. Requirements Current licensure as LMSW, LCSW, LPC, LMFT, or LAMFT. Master's degree in a human services field (e.g., social work, counseling, psychology), with postgraduate clinical experience and appropriate clinical endorsement. Demonstrated knowledge of administrative procedures related to Federally Qualified Health Centers (FQHCs) or other federally funded community health settings. Proficiency in computer applications required for maintaining electronic health records (EHR) and effective internal communication. Essential Functions: Deliver direct therapeutic services to clients, utilizing evidence-based practices. Conduct assessments and provide accurate clinical diagnoses. Maintain up-to-date and compliant counseling charts; routinely audit for accuracy and completeness. Complete service notes within 48 hours of client contact in alignment with documentation standards. Participate in daily ACT team meetings (Monday through Friday) to ensure coordinated care. Attend monthly Mental/Behavioral Health meetings, as well as staff, provider, and other organizational meetings as required. Ensure compliance with state and federal documentation and service delivery guidelines. Demonstrate knowledge and application of evidence -based therapeutic models and best practices. Exhibit professional role modeling, organizational, communication, and client engagement skills. Attend and actively participate in off-site trainings, meetings, and seminars as needed. Maintain regular and predictable attendance, as it is an essential function of this position. Coordinate and participate in the activities of the Individual Treatment Team (ITT), including building a comprehensive understanding of each client's life circumstances, goals, and preferences, collaborating with clients to develop and revise individualized treatment plans, presenting treatment options and ensuring plans are responsive to evolving client needs, advocating for client rights, wishes, and personalized care preferences. Perform other related duties as assigned to support program goals and client outcomes. Key Success Factors: In-depth understanding of industry standards, as well as state and federal licensure rules and regulations. Ability to engage in and apply reciprocal feedback from both colleagues and clients to improve service delivery. Proven experience providing therapeutic counseling services in a clinical or community-based setting. Strong commitment to professional ethics, with strict adherence to the code of ethics governing licensed disciplines. Comprehensive knowledge of local community resources and demonstrated networking abilities to support integrated care. Familiarity with the Assertive Community Treatment (ACT) model and a clear understanding of how its service delivery differs from traditional approaches. Hands-on experience delivering at least one ACT community-based service-such as Community-Based Rehabilitation Services (CBRS), Case Management (CM), or Peer Support Services (PSS)-or completion of a minimum six-month direct-service internship with an ACT team. Job Overview Working Conditions: Work is normally performed in a typical interior, medical work environment in a clinic building. Work may be demanding and chaotic at times. May be exposed to a patient population that will present a variety of contagious diseases, physical injuries, and emotional states of mind. Ability to solve complex practical problems. Positive interpersonal, communication & persuasion skill over the phone, computer & in person. Must be able to simultaneously manage several objectives and assign priorities. Deal with a wide variety of variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written or oral form. Ability to work effectively under pressure to meet deadlines with a strong organization skill set for easy retrieval of information and to ensure competent closure of issues. Demonstrated good judgment, sounds decision-making, and effective conflict management skills that inspire confidence and trust form clients and stakeholders. Ability to conduct complex analysis and apply deductive reasoning to draw logical, informed conclusions. Physical Requirements and Work Environment: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions. Must be able to stand, sit, and be mobile for one-third to two-thirds of the workday Reaching with hands and arms occurs approximately one-third of the workday Occasional climbing, balancing, stooping, kneeling, or crouching (less than one-third of the time) Requires frequent verbal communication and active listening (over two-thirds of the time) Must be able to lift or exert force up to 10 pounds approximately 50% of the time, and up to 25-40 pounds less than one-third of the time Rarely required to lift more than 41 pounds Must be capable of efficient keyboard use and possess the ability to hear, see, speak, and read effectively
    $53k-69k yearly est. 60d+ ago
  • Care Review Clinician

    Integrated Resources 4.5company rating

    Clinical case manager job in Spokane Valley, WA

    Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow. We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity. Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success. Job Description To provide clinical expertise in the application of medical and reimbursement policies within the claim adjudication process through claim review, medical record review and research. To provide expert knowledge in CMS, NCCI, AMA and other nationally published guidelines for correct coding and billing accuracy. Evaluates medical records and/or medical notes providing clinical expertise on coding accuracy. Reviews for provider reconsideration requests related to claim edits and validation outcomes. Utilizes established criteria for review of complex medical claims and refers to Chief Medical Officer or Medical Director for determinations when criteria are not met . Acting as a clinical resource, provides clinical review of claims to determine coding and billing accuracy and medical appropriateness of various types of provider claims. Reviews claims for correct billing and coding using Medicare Provider Manual guidelines. Documents clinical review summaries, bill audit findings and audit details in the data base. Identifies and reports quality of care issues to the Quality Management Department. Reports suspected member or provider fraud per Healthcare Policy. Identifies and refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. Participates in the development and implementation of proactive approaches to improve and standardize overall retrospective. Qualifications clinical experience from a hospital (Preferred) . Min. 2- 3 years clinical nursing experience . 1 year of utilization review or medical claim review . RN License Required . Preferred Experience in one of more of the following areas critical care, emergency medicine, surgical. paediatrics, advanced practice nursing, and billing and coding experience . Great organizational skills . Critical thinkers and the ability to make decisions using clinical background/knowledge . Able to work independently . Able to collaborate and work with peers to make decisions . Knowledge of state and federal regulations In-depth Knowledge of ICD-9, CPT, and HCPTS . Additional Information All your information will be kept confidential according to EEO guidelines.
    $74k-103k yearly est. 60d+ ago
  • Care Review Clinician

    Integrated Resources 4.5company rating

    Clinical case manager job in Spokane Valley, WA

    Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow. We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity. Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success. Job Description To provide clinical expertise in the application of medical and reimbursement policies within the claim adjudication process through claim review, medical record review and research. To provide expert knowledge in CMS, NCCI, AMA and other nationally published guidelines for correct coding and billing accuracy. Evaluates medical records and/or medical notes providing clinical expertise on coding accuracy. Reviews for provider reconsideration requests related to claim edits and validation outcomes. Utilizes established criteria for review of complex medical claims and refers to Chief Medical Officer or Medical Director for determinations when criteria are not met . Acting as a clinical resource, provides clinical review of claims to determine coding and billing accuracy and medical appropriateness of various types of provider claims. Reviews claims for correct billing and coding using Medicare Provider Manual guidelines. Documents clinical review summaries, bill audit findings and audit details in the data base. Identifies and reports quality of care issues to the Quality Management Department. Reports suspected member or provider fraud per Healthcare Policy. Identifies and refers members with special needs to the appropriate Molina Healthcare program per policy/protocol. Participates in the development and implementation of proactive approaches to improve and standardize overall retrospective. Qualifications clinical experience from a hospital (Preferred) . Min. 2- 3 years clinical nursing experience . 1 year of utilization review or medical claim review . RN License Required . Preferred Experience in one of more of the following areas critical care, emergency medicine, surgical. paediatrics, advanced practice nursing, and billing and coding experience . Great organizational skills . Critical thinkers and the ability to make decisions using clinical background/knowledge . Able to work independently . Able to collaborate and work with peers to make decisions . Knowledge of state and federal regulations In-depth Knowledge of ICD-9, CPT, and HCPTS . Additional Information All your information will be kept confidential according to EEO guidelines.
    $74k-103k yearly est. 3h ago
  • Clinic Based Counselor |Full-Time|

    Heritage Health 3.9company rating

    Clinical case manager job in Kellogg, ID

    Heritage Health is seeking a full-time (1.0 FTE) Counselor to join our team in Kellogg, Idaho. Who will work as part of a multidisciplinary team to provide mental health services. We prioritize work-life balance and offer a supportive environment to ensure our team members thrive both professionally and personally. $3,000 Sign-On Bonus Why You Should Join our Dynamic Healthcare Team: Passionate Purpose: We're committed to enhancing lives, every day. Unmatched Support: We are committed to a fun and supportive team environment. Balanced Lifestyle: No weekends or holidays, ensuring a healthy work-life balance. Collaborative Care: Work with a dedicated team to provide the best patient outcomes in the right settings. Exceptional Rewards: Competitive pay, and benefits Benefits: Health Insurance: 100% employer-paid employee coverage for medical, dental, and vision plans for full-time employees. Life Insurance: Employer-paid for 1x annual salary (optional coverage available for additional cost). Disability Insurance: Short-term disability insurance based on age & salary. 100% employer-paid long-term disability insurance. Retirement: 403 (b) plan: Heritage Health matches up to 4% of employee contributions. Paid Time Off Benefits: 120 hours Paid Time Off (PTO) in your first year, 56 hours Extended Illness Bank (EIB) in your first year, 8 paid holidays for full-time employees, amounts are pro-rated for part-time employees who are .5 FTE or higher. Employee Assistance Program (EAP): Enjoy free telehealth visits for healthcare, counseling, and health and wellness coaching for all employees and their immediate household members. Requirements LCSW, LPC, LCPC, LMFT, LAMFT or LMSW; Master's degree in human service field with post graduate experiences and clinical endorsement. Working knowledge of Administrative procedure of a Federally funded community health center. Computer skills necessary to maintain client charts and communication within the organization. Must be able to pass Idaho Department of Health and Welfare Criminal History Unit enhanced background check. Knowledge, Skills, and Abilities Required: Knowledge of industry standards and licensure rules and regulations. Participate in reciprocal feedback from counselors and clients. Previous experience in counseling. Adhere to code of ethics for licensed discipline. Knowledge of community resources and networking skills. Duties and Responsibilities: Provide direct therapeutic services. Maintain and audit counseling charts. Attend monthly Mental/Behavioral health meeting. Attend all staff, provider meetings, and other meetings as necessary. Compliance with documentation standards set by the state and federal guidelines. Assessment and diagnosis. Service note completion within 48 hours of contact. Knowledge and use of evidence-based best practice therapeutic models. Role modeling, organizational, communication and guest-relation skills. Willingness to attend and participate in off-site meetings and/or seminars. Regular and predictable attendance is an essential function of this position. Other duties as assigned. Safety: Heritage Health enforces a safety culture whereby all employees have the responsibility for continuously developing and maintaining a safe working environment. Each employee is responsible for completing all training requirements, participating in emergency response tasks as requested, and serving on safety committees and teams as requested. In addition, employees must accept the responsibility for maintaining the safety of themselves and others by adhering to all written and verbal instructions, promptly reporting and/or correcting all hazards or unsafe conditions and providing feedback to supervisors and management on all safety issues. Physical Demands: Required to stand, sit, and be mobile one-third to two-thirds of the time. They are required to use hands or fingers to handle or feel over two-thirds of the time; while reaching with hands and arms occurs one-third of the day. Climbing or balancing, stooping, kneeling or crouching occur less than one-third of the time. Communicating by talking/hearing occurs over two-thirds of the day. Amount of time spent lifting or exerting force is about 50% for up to 10 pounds and less than one-third of the time up to 25 - 40 pounds. Rarely is there a need to lift more than 41 pounds. Must be able to manage efficient keyboard use, hear, see, speak and read. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to solve complex practical problems Positive interpersonal, communication & persuasion skills over the phone, computer & in person Must be able to simultaneously manage several objectives and assign priorities Deal with a wide variety of variables in situations where only limited standardization exists Ability to interpret a variety of instructions furnished in written or oral form Ability to work effectively under pressure to meet deadlines with a strong organization skill set for easy retrieval of information and to ensure competent closure of issues Ability to work overtime as needed, maintain alertness & meet the controlled substance policy. Good judgment and sound decision making and conflict management skills to inspire confidence from the customer Manage complex analysis and use deductive reasoning Working Conditions: Work is normally performed in a typical interior/office work environment. Work may be demanding and chaotic at times. Exposed to patient population that will present a variety of contagious diseases, physical injuries and emotional states of mind.
    $41k-48k yearly est. 60d+ ago

Learn more about clinical case manager jobs

How much does a clinical case manager earn in Coeur dAlene, ID?

The average clinical case manager in Coeur dAlene, ID earns between $37,000 and $67,000 annually. This compares to the national average clinical case manager range of $38,000 to $68,000.

Average clinical case manager salary in Coeur dAlene, ID

$50,000
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