Providence Program Manager Provider Relations Accreditation and Compliance in Portland, Oregon
Providence St. Joseph Health is calling a Program Manager Provider Relations Accreditation and Compliance to our location in Portland, OR.
We are seeking a Program Manager Provider Relations Accreditation and Compliance who will be responsible to write and maintain all Network Adequacy and Network Management policies, all NCQA or other Network accreditation standards and responses. Responsible for analysis of Network adequacy to meet State requirement and develop remediation strategies as needed. Responsible to develop policies and programs to address Health Equity. The Program Manager is responsible to write and maintain all network management policies for maintaining and disseminating information for all regulatory and accreditation requirements, as well as ensuring department managers and supervisors have processes in place to meet those requirements in both Provider Relation's and Behavioral Health Network. The program manager is responsible for the overall readiness assessment of the departments, as well as keeping program leadership informed of potential risks and ongoing resource needs. This position will track and report on progress and potential risks through various program oversight committees and directly with the Senior Manager, Provider Relations/Behavioral Health Network.
In this position you will have the following responsibilities:
Responsible for the dissemination of regulatory and accreditation requirements to department teams responsible for implementation.
Maintain subject matter expertise in department regulations and standards.
Maintain up to date knowledge of standards and works with department leadership to update/modify policies and programs to maintain compliance.
Design and conduct readiness audit processes to monitor accreditation and regulatory requirements.
Participate in regulatory and accreditation audits, site surveys and needed preparation of work teams, in the writing and compilation of required documentation and reports.
Participate in and assume a leadership role in joint operating councils.
Participate in Heath Plan committees and prepare reports for required regulatory and accreditation reporting.
Support Department leadership in Managing the delegation program; regularly meet with delegated groups to share information and provide feedback of the audit and monitoring and develop corrective action plans for continuous quality improvement.
Identify opportunities and actively participate in process improvement related to enhancing health plan quality and maintaining compliance with external standards and regulations.
Required qualifications for this position include:
Bachelor's Degree in Business, Healthcare or closely related field.
5 years related experience working in or with a managed care organization or experience in a healthcare field.
3 years demonstrated track record in developing effective business relationships and working cooperatively with others.
Preferred qualifications for this position include:
Master's Degree in Business, Healthcare or closely related field.
1 year demonstrable project manager and/or program manager experience, including program planning, development and evaluation.
1 year experience with CMS, Medicaid, NCQA, URAC accreditation and survey process.
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 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: Project & Program Management (Non-Clinical)
Req ID: 287499