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Take advantage of an exciting opportunity to join Providence Medical Group as a full-time Primary Care physician in Spokane, Washington. You will be at one of 11 primary care clinics within a collaborative network where you will have easy access to system-wide support as you work alongside a highly motivated and skilled Primary Care team. A team-based approach to patient care is the model of care including increase Provider to MA ratio (minimum 1:1.5), Clinic RN’s, prescription refill support, remote inbox coverage when you are out of office, ambulatory Pharmacist, and RN Care Navigators. We offer new and emerging technologies to support providers including DAX ambient transcription using AI generated notes and remote patient monitoring services to care for patients with many difficult to control chronic conditions. Jump on this amazing opportunity while being part of a mission-oriented and highly dedicated team of providers making an impact throughout Eastern Washington. • Generous call schedule, • Easy access to system-wide consulting specialists, • Compensation is between $241,044 and $337,879 per year, • The compensation amounts listed may include productivity or quality/service incentives, call pay, extra shift incentives, as applicable to the position. In addition, providers may have CME benefits available to them., • Comprehensive benefits including health, vision, dental and retirement, • New graduates are welcome to apply Where You’ll Work Providence Medical Group - Eastern Washington is a physician-led network of more than 700 primary and specialty care providers in clinic locations across Spokane and Stevens counties. Offering patient-centered care, Providence Medical Group partners with some of the region’s most advanced hospitals, including Providence Sacred Heart Medical Center & Children’s Hospital, Providence Holy Family Hospital, Providence Mount Carmel Hospital and Providence St. Joseph’s Hospital. Where You’ll Live Spokane Valley is located about 10 miles east of Spokane, Washington, and 23 miles west of Coeur d'Alene, Idaho. It is home to the Spokane Valley Mall and a host of recreational opportunities with its 11 city parks, three city pools and seven miles of the popular Centennial Trail. Located close to the Spokane International Airport, it has a low cost-of-living and no income tax. Who You’ll Work For Providence is a nationally recognized, comprehensive healthcare organization spanning seven states with a universal mission — to provide compassionate care to all who need its services, especially the poor and vulnerable. Its 122,000-plus caregivers/employees (including 34,000 physicians) serve in 51 hospitals, more than 1,000 clinics and a comprehensive range of health and social services. Providence: One name, one family, one extraordinary health system. Check out our benefits page for more information. Equal Opportunity Employer including disability/veteran Job ID Number: 27425

The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. At least 3

The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. At least 3

Job Description 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., • Become an anti-racist organization 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 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., • 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., • 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. As part of our hiring process, the following criteria must be met: • 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) 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. At this time, we are offering a $3,000.00 sign-on bonus for this opening. 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 Sensory*: • Extended periods of sitting, computer use, talking, and possibly standing 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.