**Description** PeaceHealth is seeking a RN VBC Complex Care Manager for a Full Time, 1.00 FTE, Day position. This position may be in Ketchikan, Alaska or Bellingham, Washington. The salary range for this job opening at PeaceHealth is $49.64 – $74.46. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc. **Ideal candidate has the following experience:** + **Telephone support** + **Chronic Care Management** + **Utilization review** + **Patient advocate** + **Population Health** Responsible for managing and optimizing patient care through prospective, concurrent and retrospective utilization management. Works with Value Based Care (VBC) team and Care Management teams to identify cost savings and repatriation opportunities in our VBC patient populations. Implements patient specific interventions to support VBC initiatives. Emphasis on ensuring high-quality, cost-effective care alternatives while enhancing patient experience and supporting seamless transitions between various clinical and non-clinical settings across the care continuum. **Details of the position:** + Perform comprehensive retrospective, prospective and concurrent reviews to assess medical necessity and identify cost-effective care alternatives where appropriate. + Identify and support the repatriation of patients to in-network care when appropriate to the patient’s condition, ensuring seamless transitions and continuity of care. Collaborate with multidisciplinary teams to facilitate these processes. + Analyze clinical data and utilization patterns to identify trends, gaps, and opportunities for improvement. Utilize findings to inform decision-making and drive quality improvement initiatives. + Provide comprehensive case management services to VBC populations, educating and empowering patients and families about health conditions and self-management strategies. Leveraging motivational interview techniques and teach back methods. + Act as a liaison between patients and healthcare clinicians to ensure continuity of care across care settings. + Track, evaluate, and provide oversight for transitions of care, synchronizing “warm handoffs” between the clinic and hospitals, emergency departments or care facilities. Facilitates and ensures the sharing of information across people, functions, and sites. + Participate in the development and implementation of clinical quality initiatives aimed at reducing total cost of care, improving clinical outcomes and enhancing patient experience. + Assist in achieving clinical quality metrics by engaging in patient outreach to facilitate necessary screenings, vaccinations, and follow-up appointments to improve overall health outcomes. **What you bring:** + Accredited School of Nursing required. + Bachelor's Degree Required: Nursing. + **Minimum of 5 years required: Clinical nursing experience, with a focus on utilization management, medical necessity reviews or care coordination.** **Credentials** + Required: Registered Nurse In state of practice. + **Required: Registered Nurse Licensure in Washington, Oregon and Alaska.** + Required: Basic Life Support. + Proficient use of computers including MS Office applications and other applicable software applications (Required) + Ability to develop strategies for staff and patient education (Required) + Strong communication skills, both verbal and written (Required) + Understanding of Medicaid/Medicare standards and requirements (Required) + Must be able to work both independently and interdependently with staff and team members with limited supervision (Required) + Excellent organizational, problem solving, and critical thinking skills (Required) + Ability to maintain documentation systems of care and tracking of patients (Required) + Ability to develop and maintain patient resources for education and referral (Required) + Strong medical background and knowledge of critical care (Required) + Working knowledge of psychiatric diagnostics (Required) + Ability to work in an independent and remote environment as position may be a hybrid of onsite and remote work (Required) PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program. See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility (https://www.thecaregiver.org/wp-content/uploads/2017/05/PeaceHealth-Statement-of-Commitment-to-Diversity-and-Inclusion-vFINAL.pdf) . For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws. REQNUMBER: 112377