Supervisor Of Utilization Medical Management

Providence Health & Services Beaverton , OR 97075

Posted 2 months ago

Providence St. Joseph Health is calling a Supervisor, Health Care Services to our location in Beaverton, OR.

We are seeking a Health Care Services (HCS) Clinical Support Supervisor to be responsible for the daily operations of the Utilization Medical Management department. This position oversees the registered nurses and technicians within the Utilization Medical department. The supervisor works collaboratively with the Manger of UM, to meet the goals of the department. This includes proactively managing inpatient utilization to assure that medical care is appropriate, efficient and medically necessary, while supporting discharge planning efforts, transfers and coordination of care. The supervisor is a liaison to hospitals, skilled nursing facilities, health plans, and other Providence Health Plan departments. In this role, the supervisor acts as a mentor and role model; problem solving day to day issues and promotes team building that reflects the Providence mission and core values.

In this position you will have the following responsibilities:

  • Oversee the daily activities of staff, including hiring and performance management.

  • Provide day to day oversight for department operations and problem solving as issues arise.

  • Provide a supportive, team-based environment that facilitates group decision making and employee empowerment.

  • Evaluate performance and initiates personnel actions such as hiring, merit increases, probationary and periodic reviews, promotions, transfers between teams and disciplinary actions.

  • Develop and maintain positive relationships with providers and facilities; maintain knowledge in subject matter and enhance Health Plan expertise in the area of CM and UM.

Required qualifications for this position include:

  • Bachelor's Degree in Health related field or applicable work experience may be substituted for some education.

  • 2 years experience with managed care services including population health initiatives, Affordable Care Act, Coordinated Care Organizations, Accountable Care Organizations, Medicare and Medicaid regulations.

  • Experience with development of innovative and focused partnerships and programs which challenge the norm to support an ever changing healthcare environment.

  • Experience in cost stewardship using Lean principles or other means which increase effectiveness and cut waste.

  • Experience with the latest trends in health education and behavior change.

  • Demonstrated experience in project management, educational program development and implementation, and technology.

  • Current licensed driver.

Preferred qualifications for this position include:

  • Advanced Degree

  • Bachelor's degree in Nursing or related field

  • Additional job-related and company approved certifications such as Certified Nursing Assistant, Certified Medical Assistant or Certified Med Aid.

  • Active, unrestricted Oregon or Washington RN license

  • Certification in Utilization Management or Case Management

  • 2 years clinical experience in an inpatient or outpatient healthcare setting

  • Supervisory or management experience in a managed care setting

  • Concurrent review knowledge and experience using utilization management tools such as Interqual or Milliman criteria

  • Demonstrated ability to effectively manage change and conflict

  • Demonstrated ability to work effectively with others as a team member

  • Attentiveness to detail, exhibiting self-direction, effective oral and written communications skills

About Providence in Oregon.

As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.

The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,

"Providence will provide the best care and service to every person, every time."

Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.

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Supervisor Of Utilization Medical Management

Providence Health & Services