Disease Management Program Manager

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age. Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths. The Disease Management Program Manager is responsible for the implementation and management of the PacificSource Disease Management Program(s). The role will analyze, report and monitor the internal Disease Management efforts and provide recommendations to leadership on matters related to the expansion and scalability of the Disease Management Program for all lines of business. Essential Responsibilities: In collaboration with Case Management (CM), Wellness and other business unit leaders, the Disease Management Program Manager will build and maintain a structure around Disease Management offerings supported by policies, processes, procedures, workflows, and technology. Develop and maintain Internal Disease Management programs, policies and procedures. Implement a comprehensive Disease Management program that improves member health outcomes and enhances their member experience. Align internal disease management programs with external vendor programs. Communicate the program vision and strategic roadmap and program metrics to all stakeholders on a regular basis. Create and maintain workflows for referral to and from Coaching to CM and vendors if applicable. Train team members and associated work streams on workflow. Contact and coach members (phone, email, text, chat) who enroll in internal PacificSource Disease Management programs. Use evidence based Motivational Interviewing techniques to help program participants engage in self-management and achieve optimal health. Access program participants for risk, clinical outcomes, SDOH and refer member to appropriate services, tools and providers. Collect, document, and assess patient information pertinent to member’s history, condition, and functional abilities. Willing to work flexible hours to accommodate member’s needs: Evening, early morning. Collaborate with Community Bases Organizations and align processes with the Social Determinants of Health and Equity Program Manager Work with analytics and other SMEs to enhance member identification. Create education campaigns using vendor or Healthwise materials. Collaborate with service center and Health Programs Coordinator to maintain member mailing and program invites. Lead NCQA/Medicaid compliance for Disease Management Programs. Supporting Responsibilities: Work on designated committees, teams, and task groups, as directed. Assist with any other duties that may be required for efficient functioning of the team and department. Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Perform other duties as assigned. SUCCESS PROFILE Work Experience: Five years nursing experience with varied clinical experience or related experience. Experience in health coaching, disease management, and/or chronic condition management (adults or children) preferred. Education, Certificates, Licenses: Registered Nurse with current Oregon License required. Willingness to obtain RN licensure in other states as requested. Disease Management certifications preferred (Diabetes Educator, etc.). Knowledge: Understanding of Motivational Interviewing techniques to facilitate health teaching and coaching. Experience with program development, implementation, and management. Work effectively with people who have a variety of health issues, concerns, and personality styles. Knowledgeable of, or the research skills to locate, community services, providers, vendors and facilities available to assist members. Maintain clinical knowledge base. Effective technical writing skills. Good organizational skills with experience in using computers and various software applications including Word, Excel, PowerPoint, and Outlook. Ability to work independently with minimal direction. Competencies: Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 10% of the time. Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Group Problem Solving, Listening (active), Organizational skills/Planning and Organization, Teamwork Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times. PacificSource is anything but a typical health insurance company. Founded in 1933, we’re an independent, not-for-profit organization that puts our members, and their communities first—across Idaho, Oregon, Montana, and Washington. It's our 1,900 employees who make it happen: promoting health equity and partnering with providers to deliver better access to optimal, affordable care. So yes, with PacificSource, you get to do great things. In our effort to put members first—more than 600,000 of them—initiative, commitment, and hard work are supported and rewarded with excellent benefits, competitive wages, and opportunities for personal growth and advancement. Benefits: Flexible telecommute policy, medical, vision, and dental insurance, incentive program, paid time off and holidays, 401(k) plan, volunteer opportunities, tuition reimbursement and training, life insurance, and options such as a flexible spending account. We love our common purpose. Empowerment, flexibility, and sharing success make for a great place to work. Here’s what else we feel good about: A mission with a real sense of shared values Competitive wages and outstanding benefits, including telecommuting Opportunities for learning development and career advancement Organizational leadership style rooted in servant and transformational leadership A commitment to support the communities we serve A belief in the importance of work-life balance April 16: Central Oregon Community College Job Fes, 10a-1p (2600 NW College Way, Bend, OR 97703) April 17: Oregon State Spring Career Fair, 11a-3p at Career Center (725 Southwest 26th Street, Corvallis OR 97331) April 18: University of Oregon Spring Career Fair, 12p-4p at the EMU Ballroom (1395 University St, Eugene OR 97403) April 24: Linn Benton Community College Career Fair, 10a-2p (6500 Pacific Blvd SW, Albany OR 97321) May 14: Idaho Business League, 10a-2p at Courtyard by Marriot (1789 S Eagle Road, Meridian ID) PacificSource is an equal opportunity employer and a company that loves helping people. We work with our employees to understand their goals, and provide training, individual development, and career advancement opportunities to help them achieve just that. In 2023 alone we had 407 internal promotions! Certified Age Friendly Employer, 2023 | Age Friendly Institute Top Workplace 2023 and 2022 for Idaho | Idaho Press Top Workplace 2023 and 2022 for Oregon and SW Washington | The Oregonian #4 Healthiest Employer of Oregon 2021 | Portland Business Journal Healthy Worksite 2021 | Design Coalition in Montana PacificSource is an equal opportunity employer. Click here to review our AAP Policy Statement. If you have questions about working at PacificSource or need help with your application, please email HRrecruiting@PacificSource.com.