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Full Details :
Company Name :
Samaritan Health Services
Location : 3000 Po Box, Corvallis, OR 97339
Position :

Job Description : Req #: 56803
Samaritan Health Services
Corvallis, OR
SHS Health Plan Ops – CMO
1.0 (80 hrs/pp) – Day
Start / End Time: 0830 (8:30am) – 1700 (5:00 pm)
Overtime Rule: 40
$18.96 – $27.84
JOB SUMMARY/PURPOSE
Leads the authorization process. Provides oversight, QA checks and training to ensure the authorization process is completed in a member-centered manner with adherence to quality and timeline standards. Participates in Department or health plan projects and/or committees.
DEPARTMENT DESCRIPTION
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
EXPERIENCE/EDUCATION/QUALIFICATIONS
High school diploma or equivalent required.
Four (4) years managed care authorization experience required.
Experience and/or training in the following required:
MS Office with an emphasis in Word and Excel
Managed care software
Experience and/or training in ICD-10/CPT coding preferred.
KNOWLEDGE/SKILLS/ABILITIES
Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.
Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.
Ability to work, function and communicate on a multi-disciplinary team. Possess the knowledge and skills to develop constructive and cooperative working relationships with others and maintain them over time.
Ability to organize, plan and prioritize work to complete within required time frames and to follow-up on pending issues. Ability to perform multiple tasks simultaneously and thrive in dynamic fast-paced environments and under pressure.
Leads effectively with excellent verbal and written communication. Delegates and initiates cross-functional teams and multi-disciplinary projects
Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management
PHYSICAL DEMANDS
Rarely
(1 – 10% of the time)
Occasionally
(11 – 33% of the time)
Frequently
(34 – 66% of the time)
Continually
(67 – 100% of the time)

CLIMB – STAIRS
LIFT (Floor to Waist: 0″-36″) 0 – 20 Lbs
LIFT (Knee to chest: 24″-54″) 0 – 20 Lbs
LIFT (Waist to Eye: up to 54″) 0 – 20 Lbs
CARRY 1-handed, 0 – 20 pounds
BEND FORWARD at waist
KNEEL (on knees)
STAND
WALK – LEVEL SURFACE
ROTATE TRUNK Standing
REACH – Upward
PUSH (0 – 20 pounds force)
PULL (0 – 20 pounds force)
SIT
CARRY 2-handed, 0 – 20 pounds
ROTATE TRUNK Sitting
REACH – Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/Fist

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By Richard