Providence is calling a Supervisor Health Care Services (HCS) Medical Management with Providence Health Plan Partners to be located in Oregon or SW Washington.
The Supervisor Health Care Services (HCS) Medical Management Supervisor is responsible for providing day to day oversight for the general operations of the Care Management or Utilization Management teams within HCS and works in cooperation with the Manager to provide leadership and guidance in one or more of the following areas: care management, prior authorization, concurrent review, clinical claims audit and appeals. In addition to supervisory responsibilities, duties include all functions of HCS daily operations including providing case management or medical review, coordination and assistance to patients with complex health needs or the potential for poor health outcomes. 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.
Graduation from an accredited school of nursing -OR-
Graduation from an accredited clinical program (i.e.: Council on Social Work Education)
Applicable work experience may be substituted for some education.
Clinical license in good standing in the state of Oregon; as applicable.
5 years Clinical experience.
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 supporting teams with electronic processing systems.
Proven track record of delivering process and fiscal improvements leading to increased efficiencies and overall savings.
Experience in working with physicians in collaboration and management of patient care.
Demonstrated experience in project management, educational program development and implementation, and technology.
Bachelor's Degree in Nursing or other Clinical degree.
Certifications in Areas of Expertise:
Certified Case Manager.
Certification in Utilization Management
Supervisory or lead experience.
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
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.
We offer a full comprehensive range of benefits — see our website for details — http://www.providenceiscalling.jobs/rewards-benefits
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Nurse Lead/Supervisor/Manager
Other Location(s): Oregon, Washington-Vancouver
Req ID: 359966