Job Information

Providence Medical Management Program Manager in Beaverton, Oregon


Providence is calling a Medical Management Program Manager who will:

  • Work in close partnership with leaders throughout HCS and PHP to support and lead key initiatives that enhance operational efficiency, manage medical expense, improve quality for our members, provider partners and customers

  • Provide internal project management support through all project phases and leverages process improvement philosophies such as Lean and CAP to drive operational and quality improvement activities, new program and software implementations and establishes performance metrics and reporting for ongoing evaluation

  • Operate in a highly matrixed environment to lead program administrative activities for Utilization Management (UM), Care Management (CM) and Health & Wellness programs

  • Support committee agenda planning, minutes, and presentations

  • Coordinate data analysis, interpret and develop outcome recommendations that demonstrate the impact and value of various medical management programs

  • Periodically develop and present internal and external facing presentations for diverse audiences

  • Coordinate and collaborate with internal and external stakeholders, customers and manage vendor partner relationships to achieve the service levels and organizational goals and objectives aligned to the strategic & financial plan as well as the mission and core values

Primary Responsibilities:

  • The Health Care Services division is highly matrixed with multiple functional areas that are broad in scope and require a depth and breadth of skills, knowledge, and experience. Therefore, the principle duties and functions of an individual Medical Management Project Manager will vary depending on the dynamic environment and business needs

  • Works closely with HCS and Health Plan leaders as well as independently to lead and insure projects and programs achieve the organizations strategic and financial goals & objectives

  • Identifies and actively participates in process improvement opportunities and new program implementations

  • Develops, maintains, tracks and reports on status of project plans and portfolios to various leaders and committees

  • Supports various committees with agenda planning, data requests and aggregating, creating and providing presentations, minutes and coordination of sub-group work requests

  • Supports quality improvement initiatives and overall program evaluation and work plans as well as creation, review and revision of policies and procedures as necessary

  • Coordinates and collaborates with business partners and customers to complete request for proposals (RFP's) for new and existing business

  • Provides oversight and liaises vendor relationships, contract execution and contract compliance

  • Supports development, analysis and reporting of program outcomes

  • Coordinates and collaborates risk assessments with cross-functional leaders and supports investigation, further assessment, recommendations and action plans for remediation and tracking

  • Customer focused - actively participates in new business opportunities, provides excellent customer service to both external and internal stakeholders and business partners

  • Liaison with other Health Plan and PSJH delivery system departments and programs, provider groups, coalitions and state/federal and accreditation agencies

Required qualifications for this position include:

  • Bachelor's Degree

  • Training in Change Acceleration Process (CAP) or related process improvement tools and or experience

  • Experience in project management, program management and evaluation, team facilitation, data analysis, and/or medical management

  • 3 years' experience in project coordination / management

Preferred qualifications for this position include:

  • Master's Degree in Business Administration, Management, Healthcare Administration, Public Health, Public Administration, or a clinically related field

  • Certification in Lean upon hire

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 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.

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.

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.

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.

We are committed to cultural diversity and equal employment for all individuals. It is our policy to recruit, hire, promote, compensate, transfer, train, retain, terminate, and make all other employment-related decisions without regard to race, color, religious creed (including religious dress and grooming practices), national origin (including certain language use restrictions), ancestry, disability (mental and physical including HIV and AIDS), medical condition (including cancer and genetic characteristics), genetic information, marital status, age, sex (which includes pregnancy, childbirth, breastfeeding and related medical conditions), gender, gender identity, gender expression, sexual orientation, genetic information, and military and veteran status or any other applicable legally protected status. We will also provide reasonable accommodation to known physical or mental limitations of an otherwise qualified caregiver or applicant for employment, unless the accommodation would impose undue hardship on the operation of our business.

We are a community where all people, regardless of differences, are welcome, secure, and valued. We value respect, appreciation, collaboration, diversity, and a shared commitment to serving our communities. We expect that all workforce members in our community will act in ways which reflect a commitment to and accountability for, racial and social justice and equality in the workplace. As such, we will maintain a workplace free of discrimination and harassment based on any applicable legally protected status. We also expect that all workforce members will maintain a positive workplace free from any unacceptable conduct which creates an intimidating, hostile, or offensive work environment.

Requsition ID: 108577
Company: Providence Jobs
Job Category: Member Services Enrollment & Billing
Job Function: Health Plans Services
Schedule: Full time
Shift: Day
Career Track: Business Professional
Address: OR Beaverton 3601 SW Murray Blvd

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.