Program Manager- Medical Management
About The Position
Program Manager - Medical Management - Remote Under the direction of the Head of Providence Health Plan Payment Integrity (PI), the program manager of PI is responsible for the development, evaluation, coordination, implementation, and monitoring of all PI initiatives across the health plan. The PI manager oversees and drives all aspects and outcomes of PI through strategic matrixed relationships, ensuring initiatives have been appropriately communicated and prioritized across a wide range of stakeholders. Primary responsibilities include detailed tracking of initiatives with established data and expected ROI savings estimates, creation of manual and automated workflow pathways, plan policy development, and regulatory, contract, and benefit vetting. This role is responsible for setting and driving accountability through the Plan PI Committee, including identification and escalation of roadblocks. Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team at Providence Health Plan Partners 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. This role offers 100% remote work for candidates residing in: Oregon Washington California
Requirements
- Bachelor's Degree
- 3 years Healthcare experience in project coordination encompassing operations analysis, outcomes measurement methodology, data management and quality improvement process design.
- 3 years Experience with performance improvement/organizational change tools.
- 3 years Change management experience.
- Experience in Six Sigma and/or Lean methodology
Responsibilities
- Development, evaluation, coordination, implementation, and monitoring of all PI initiatives across the health plan
- Oversees and drives all aspects and outcomes of PI through strategic matrixed relationships
- Detailed tracking of initiatives with established data and expected ROI savings estimates
- Creation of manual and automated workflow pathways
- Plan policy development, and regulatory, contract, and benefit vetting
- Setting and driving accountability through the Plan PI Committee, including identification and escalation of roadblocks
Benefits
- 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.
- Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits.
- Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Number of Employees
501-1,000 employees
