Providence Health & Services Manager - Utilization Management in Portland, Oregon
Providence is calling a Manager - Utilization Management to Providence Oregon as this position will cover all 8 minisitries across Oregon. This is a full-time (1.0 FTE), day shift position.
We are seeking Manager - Ultilization Management who will assist the Oregon Region Directors of Quality Management in support of programs by providing ongoing assessment and evaluation of hospital activities related to patient admission, transfers, and discharges in a variety of clinical settings. Accomplishes results through multiple experienced individual staff members who exercise latitude and independence in their assignments. Fosters team collaboration, sharing of workload and enhanced productivity.
In this position you will have the following responsibilities:
Direct and lead the accomplishment of program results through a team of experienced contributors who exercise latitude and independence in their assignments.
Is accountable for ensuring productivity standards, goals and objectives are met.
Maintain budget expectations.
Responsible for success and achievement of defined goals and objectives for Utilization Management Program in the Oregon Region.
Apply concepts of the nursing process, such as identification of disease, facilitation of healing, health promotion, illness prevention and patient care delivery to each task, clinical review and/or quality improvement project.
Demonstrate ability to evaluate patient status, continued stay and other utilization management activities utilizing severity of illness and intensity of services criterion.
Demonstrate understanding of compliance and regulatory requirements from Center for Medicare and Medicaid Services, The Joint Commission, state and Oregon Patient Safety Commissions
Promote a positive work environment, demonstrates and facilitates excellence in communication skills with leadership team, colleagues, patients and families.
Knowledge of reimbursement requirements, denial process and denial appeal management.
Responsible for the hiring, performance management, and annual evaluations for UM staff members.
Participate in the development and maintenance of processes to assure continuity and consistency of services, between sites.
Serves as liaison between staff and QM/MS Directors at each site to keep them current and informed of changes to standards, policies, procedures, etc.
Demonstrate understanding and utilization of tools, tones and behaviors that promote patient safety in a highly reliable organization.
Ensure the coordination of scheduling activities of assignments between sites.
Lead and coordinate assignments of duties to include performance improvement activities in Utilization Management
Required qualifications for this position includes:
Bachelor's Degree in Nursing
Current Registered Nurse with Oregon license in good standing
Five (5) years recent acute care experience.
Utilization Management/Review experience -OR- Care Management CDI
Progressive leadership experience.
Preferred qualifications for this position includes:
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
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: Nurse Lead/Supervisor/Manager
Req ID: 293950