Providence Health & Services Manager, Care Management Team in Portland, Oregon
Providence is calling a Care Management Manager - Utilization Review Quality Management (1.0 FTE, Days) to Providence Office Park Portland in Portland, OR
We are seeking a Care Management Manager that will be responsible for overseeing daily operations of case managers embedded in the PMG clinics, the Proactive Outreach Team, City Call and/or the Transition Call Team. The department provides case management services for at-risk patients, including patients with complex medical and psychosocial issues.
Lead and/or participate in department and Patient Centered Primary Care Home (PCPCH) initiatives to improve the efficiency and effectiveness of the services we offer to patients.
Operate as a strategic partner to other Oregon PH&S ministries in meeting the Triple Aim.
Provide leadership and oversight for the CM staff in Providence Medical Group clinics in Oregon and SW Washington. This includes providing coverage for other Managers.
Act as an expert resource to the care management staff, clinic staff and providers in the areas of case management, care coordination and level of care determinations.
Identify care coordination obstacles, collect data, communicate via SBAR, and provide recommendations to improve population health care coordination.
Conduct evaluations of programs and activities.
Ensure the development and updating of policies and procedures and maintain program compliance.
Promote CM and PCPCH team functioning. Improve coordination of patient care in collaboration with all other disciplines and multiple health plan partners.
Provide oversight and participate in the Best Practice Committee.
Design, implement, and evaluate processes to meet requirements for external programs (i.e., CPC , PCPCH) and internal strategic initiatives.
Participate in the development and implementation community health initiatives.
Set strategic vision for the CM team by identifying and articulating strategic goals that are in alignment with PMG, Region and System priorities.
In this position you will have the following responsibilities:
Manage, plan, develop, implement and evaluate the Care Management Program and activities. Coordinates with the East/West/South Medical Directors to focus limited resources on essential components of the care management program to include:
Resource management in facilities and home setting
Case management and care coordination for at-risk, medically or psychosocially complex patients
Support of population-based disease management programs
Appropriate use of community resources
Manage the Care Management staff, including ongoing performance assessment, the development and monitoring for improvement as needed. Hires, coordinates orientation and terminates personnel
Develop and maintain policies and procedures in support of the Care Management program
Establish and meet departmental goals, objectives and action plans, including budgetary and resource outcomes
Required qualifications for this position includes:
Bachelor's Degree in Nursing; graduation from an accredited school -OR-
Master's Degree in Social Work; graduation from an accredited program
Coursework/Training: Project management, Six Sigma, Lean, Change Acceleration Process (CAP) training -OR- extensive experience
Current License of Clinical Social Work (with Masters of Social Work)
Licensure required in OR and WA
Current recognition/certification by a national professional organization in case management or quality improvement
Three (3) years of experience and expertise in case management in a hospital, medical group/clinic, substance use treatment, insurance, State/County Seniors and Disabilities, or home health setting
Two (2) years of supervisory experience, including hiring, performance management, staff development and evaluation
Progressively responsible team leadership and/or management experience
Five (5) years of experience in a clinical setting which may include the three (3) years' experience required in care management
Verifiable success in program planning and implementation of change
Experience with utilization data analysis and reporting
Experience in case management and care coordination in community, home services, hospital, managed care plan and/or medical group setting
Preferred qualifications for this position include:
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.
For information on our comprehensive range of benefits, 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 Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. 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: Clinical Lead Supervisor/Manager
Req ID: 267690