Overview
**Description**
**_Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them._**
**Providence Health Plan’s Care Management department is hiring a Medicaid/Duals Manager, Care Management**
This leader is an expert in Oregon Health Plan (OHP) Medicaid Care Management and Medicare Advantage Care Management operations and clinical program delivery. OHP serves Oregon’s most vulnerable populations and Care Management services are key to bridging our members to healthcare. This role includes management and supervision of Medicare Advantage & OHP Care Management teams. This role is supported by supervisors, clinical program managers, licensed and non-licensed caregivers who are expert in delivering care management services.
**This role will:**
+ Be responsible for Care Management clinical programs, outcomes, and operations
+ Be responsible for CMS and OHP compliance, policy, quality, and performance related to Care Management activity and functions
+ Be responsible for collaboration and coordination with key leadership throughout Providence Health Plan and with our provider partners and medical homes
+ Support and mentors direct reports, which includes supervisors, program managers, registered nurses, social workers, clinical support coordinators, healthcare advocates and other staff as needed
+ Foster compassion and creates innovative interventions that will serve and support our members and communities. Drives knowledge and solutions to provide equity in healthcare delivery, treatments, and social interventions
+ Work in collaboration with other Care Management Managers to align common goals: providing high quality, affordable programs, and services to all members in all areas where Providence serves out our Mission
+ Cultivate relationships with Medicare affiliated plan partners, community benefit organizations, Health Share of Oregon and their partners, Oregon Health Authority, and statewide CCO colleagues and peers
**We welcome 100% remote work for residents who reside in one of the following States:**
+ Washington
+ Oregon
**Required qualifications for this position include:**
+ Graduate from an accredited school of nursing **-OR-** a Graduate from an accredited clinical program
+ Bachelor’s Degree in Nursing or other clinical field of study
+ Oregon Registered Nurse License
+ Formal education or training in supervision, management, or leadership
+ 3+ years of direct management or supervisory experience in a clinical or managed care setting
+ 5+ years of clinical experience
+ 2+ years of utilization, quality or care management experience in an insurance or managed care setting
+ Demonstrated experience in program planning, development and evaluation
**Preferred qualifications for this position include:**
+ Master’s Degree in Nursing or another related field of study
+ Certification in case management, utilization management or quality improvement
+ Certification in Project management, Six Sigma, Lean, Change Acceleration Process (CAP)
+ Experience with HEDIS, CAHPS, Medicare 5-Star Rating, NCQA and/or URAC accreditation
+ Experience in Project management, Six Sigma, Lean, Change Acceleration Process (CAP)
+ Washington Registered Nurse License – within six months of a hire date
**Why Join Providence?**
**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**
At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
**About the Team**
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment 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. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
**Requsition ID:** 260190
**Company:** Providence Jobs
**Job Category:** Care Management
**Job Function:** Clinical Care
**Job Schedule:** Full time
**Job Shift:** Day
**Career Track:** Leadership
**Department:** 5018 HCS CASE AND DISEASE GOV PRGM OR REGION
**Address:** OR Beaverton 3601 SW Murray Blvd
**Work Location:** Murray Business Ctr Beaverton-Beaverton
**Pay Range:** $51.16 – $82.36
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
