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 is calling a Supervisor HCS Medical Management who will:**
+ Be responsible for providing day to day oversight for the general operations of the Care Management or Utilization Management teams within HCS
+ Work 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
+ Be responsible for 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
+ Serve as a mentor and role model
+ Problem solve day to day issues
+ Promote team building that reflects the Providence mission and core values
**We welcome 100% remote work for residents who reside in one of the following States / Regions of Residency:**
+ Clark County in Washington State
+ Oregon
**Required qualifications for this position include:**
+ Graduation from an accredited school of nursing **-OR-** a combination of equivalent education and experience
+ Oregon Registered Nurse License
+ 5+ years of 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
+ Driving may be necessary as part of this role. Caregivers are required to comply with all state laws and requirements for driving. Caregivers will be expected to provide proof of driver license and auto insurance upon request. See policy for additional information
**Preferred qualifications for this position include:**
+ Bachelor’s Degree in Nursing or other Clinical degree
+ Advanced degree
+ Supervisory or lead experience
+ Medicare Advantage experience
**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:** 246118
**Company:** Providence Jobs
**Job Category:** Member Services Enrollment & Billing
**Job Function:** Health Plans Services
**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:** $43.39 – $70.03
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.
