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Providence Health & Services Medicare Pricing Supervisor PSJH in Portland, Oregon

Description:

Providence St. Joseph Health is calling a Medicare Pricing Supervisor PSJH to our location in Portland, OR. This position has the flexibility to be remote.

We are seeking a Medicare Pricing Supervisor PSJH to supervise a team of analysts within the Informatics department. The supervisor will lead advanced strategic quality improvement and process management initiatives across Providence Health Plans (PHP). Understanding the operational objectives of PHP, provides and directs high level analysis work (design evaluation plans, coordinate data collection across groups, partner with other analysts for reporting support, etc.). Manages multiple projects occurring at the same time within the department. Ensures compliance with policies and procedures. Provides staff support in preparation, coordination, submission, and presentation of assigned projects. Leads team meetings and acts as counsel to all staff on analysis matters. Supervises staff including hiring, assigning work, development planning, evaluating performance, training, providing direction, discipline and responding to complaints or grievances.

MAJOR CHALLENGES:

  • Leading work activities that are heavily monitored by CMS, Oregon Healthshare, NCQA and other entities.

  • Prioritizing the work to best meet the needs of multiple stakeholders.

  • Acquiring a global understanding of health plan administration, health plan providers and facilities, and health plan regulatory requirements.

  • Maintaining current knowledge and expertise in a rapidly changing environment.

  • Coaching and developing analysts toward self-direction.

  • Fostering a team environment that supports employee diversity and productivity.

  • Strong technical problem solving skills.

  • Obtaining data from varied and disparate information systems.

  • Developing analyses that appropriately address the questions posed.

  • Developing exhibits and presentations to communicate findings.

In this position you will have the following responsibilities:

  • Oversee daily operations of staff, which includes hiring and terminating, training, performance evaluations, the development of corrective action plans, and monitoring for improvement.

  • Gives direction and prioritization of work in order to meet strategic and departmental objectives. Ensures staff receives the appropriate training.

  • Maintain knowledge of current regulatory standards. Works with department leadership to update/modify policies and programs to maintain compliance with all regulatory requirements from CMS, DMAP and NCQA.

  • Collaborate across Providence departments to gain an understanding of work flows and improve cross-departmental communication and identify opportunities for improvement.

  • Provides advanced analytic and statistical support and uses quality improvement methodology knowledge and data analysis expertise to lead improvement initiatives.

  • Provides technical, database management, and analysis support for key initiatives within the Informatics department.

  • Leads new strategic data-related projects, such as Business Intelligence development, strategic PHP initiatives, and other high level projects.

  • Assures that annual, quarterly, and monthly reporting for various entities is accurate, of high quality and on-time.

  • Provides project management for large-sized, complex projects.

  • Professionally manages relationships both inside and outside of PHP.

  • Receives only general supervision, works independently.

Qualifications:

Required qualifications for this position include:

  • Bachelor's Degree In a highly quantitative field (e.g. Statistics, Mathematics, Actuarial Science, Economics, Engineering/Physics, Accounting, or Computer Science), plus 10 years of experience in data analysis or High School Education or equivalent, plus 12 years of experience in data analysis.

  • Formal training in the techniques of CQI/TQM and statistical process control methodology.

  • Data analysis experience at a decision-making level.

  • Extensive experience in the techniques of CQI/TQM and statistical process control methodology.

Preferred qualifications for this position include:

  • Master's Degree.

  • Healthcare organization/health insurer experience.

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 comprehensive, best-in-class benefits to our caregivers. For more information, visit

https://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

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.

About Us

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.

Schedule: Full-time

Shift: Day

Job Category: Non-Clinical Lead/Supervisor/Manager

Location: Oregon-Portland

Req ID: 307100

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