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Quality Medical Management Medical Review Manager buy in US, Free Classifieds Ads

Company Name:
Providence Health and Services
If you are looking for a new challenge and career growth we want to talk to you. Providence is calling a full-time Quality Medical Management Medical Review
manager
with a focuas on Utilization Management for a day shift
position
at Providence Murray Business Center in Beaverton, OR.

In this position, you will:
Participate in the development, implementation and program management of Medical/Utilization Review Programs for Providence Health Plans.
Be in a leadership position which provides ongoing vision and direction for the responsible programs.
Be responsible for evaluation of programs and activities; the development and maintenance of policies and procedures required by the Quality and Utilization Management program and maintains program compliance required by regulatory and accrediting bodies.
Be responsible for hiring and supervision of staff engaged in the various programs in Quality and Medical Management (QMM).
Be required to have management and clinical experience and expertise in core functional areas: Utilization management; quality, credentialing, case and disease management; clinical claims audit and project management.
Required qualifications for this position include:
Graduation from an accredited school of nursing or graduation from an accredited equivalent clinical program
Currently licensed as a registered nurse in good standing in
oregon
or current equivalent clinical license
Minimum 5 years clinical experience
Minimum 2 years utilization or quality management experience in medical insurance or a managed care setting
Management experience including 3 years supervisory experience
Formal education or training in supervision, management, or leadership; demonstrated successful project management and program development; demonstrated experience in program planning, development and evaluation
A strong customer service and process improvement orientation
Preferred qualifications for this position include:
Bachelor Degree in Nursing or other Clinical bachelor degree
Advanced degree
Certification in case management, utilization review, or quality improvement
Experience in quality management principles, tools and techniques
Strongly prefer strong background with Medical Utilization Review, Concurrent Review and Prior Authorization
About Providence in Oregon
As the largest health care 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 health care 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 more information and to apply please visit: providenceiscalling.
jobs
and apply for position number 48956.

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