Clinical Program Manager-RN; Health Plans

Clinical Program Manager‑RN (Health Plans)

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

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

This is a remote position. Eligible states include Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin.

The Clinical Program Manager is responsible for executing assigned program(s) that align with organizational goals and meet the needs of employees, customers, and stakeholders. This role leverages clinical expertise and system improvement skills to support assigned programs, ensuring successful planning, implementation, and oversight. The manager leads all aspects of program development and execution, collaborates with internal teams and external partners, and serves as a subject matter expert across the organization.

• Current unencumbered Oregon RN license required within 90 days of hire (other state licenses respected).
• BSN preferred;
  Master’s degree in a related field preferred.
• One year clinical nursing experience plus four years in health plan, case management, and/or utilization management.
• Experience or training in health care delivery systems and/or managed care patients.
• Computer applications: electronic documentation (e.g., MS Office, EPIC, Clinical Care Advanced).
• Preferred: team leadership, case management, Medicare and Medicaid rules and regulations, and health plan benefit structure and policy.

• Leadership – Inspires, motivates, and guides others to accomplish goals.
• Conflict resolution – Builds consensus and gains cooperation, resolving conflicts constructively.
• Critical thinking – Identifies complex problems, gathers data, considers options, and implements effective solutions.
• Communication and team building – Leads with excellent verbal and written communication; delegates and initiates cross‑functional and multidisciplinary projects.

• Rarely (1‑10% of the time)
• Frequently (34‑66% of the time)
• Continually (67‑100% of the time)

Climb stairs, lift, carry, bend, kneel, stand, walk on level surface, rotate trunk (standing or sitting), reach, push, pull, manual dexterity, finger dexterity, pinch, grasp activities as described.

Mid‑Senior level

Full‑time

Project Management and Information Technology

Hospitals and Health Care