Samaritan Health Services

Utilization Management Program Manager-RN

Samaritan Health Services • $75K — $95K *
Corvallis, OR 97330In-Person
Healthcare
5 - 7 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Unencumbered Oregon RN License required within 90 days of hire.
  • BSN degree preferred; Master's in a related field preferred.
  • One year of clinical nursing experience is required.
  • Four years of health plan utilization management experience is required.
  • Familiarity with health care delivery systems and managed care patients is essential.
  • Proficiency in computer applications, including electronic documentation and MS Office.
  • Preferred experience in team leadership, case management, and understanding Medicare/Medicaid regulations.

Responsibilities

  • Execute and oversee all elements of assigned programs from planning to completion.
  • Collaborate with multiple internal teams, vendors, and clients to ensure program effectiveness.
  • Educate and train staff on program details and procedures.
  • Lead the development and implementation of program initiatives and associated projects.
  • Work with SHS system experts to align programs with best practices.

Benefits

  • Flexible working hours to support work-life balance.
  • Opportunity for professional development and continued education.
  • Collaborative work environment with cross-functional teams.
  • Health benefits package including medical and dental coverage.
Full Job Description
  • JOB SUMMARY/PURPOSE
    • Executes program(s) that meet the needs of the organization, employees and/or customers. Plans, initiates, oversees execution of all elements for assigned program(s). Leads the development, implementation and management of assigned program(s) and associated projects. Oversees process from planning to completion. Works with multiple internal teams, vendors, clients. Responsible for explaining, training, and mentoring the entire organization on the program. Collaborates with SHS system experts to ensure focus, alignment, and best practices for the program.
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Current unencumbered Oregon RN License required within 90 days of hire. BSN preferred. Master's degree in a related field preferred.
    • One (1) year clinical nursing experience plus four (4) years health plan utilization management experience required.
    • Experience or training in the following required:
      • Health care delivery systems and/or managed care patients.
      • Computer applications including electronic documentation (e.g., MS Office, EPIC, Clinical Care Advanced).
    • Experience in the following preferred:
      • Team leadership.
      • Case management.
      • Medicare and Medicaid rules and regulations and health plan benefit structure and policy.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
    • Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
    • Critical thinking - Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
    • Communication and team building - Lead effectively with excellent verbal and written communication. Delegates and initiates/manage cross-functional teams and multi-disciplinary projects.
  • PHYSICAL DEMANDS
    • Rarely
      (1 - 10% of the time)
      Occasionally
      (11 - 33% of the time)
      Frequently
      (34 - 66% of the time)
      Continually
      (67 - 100% of the time)
      CLIMB - STAIRS
      LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
      LIFT (Knee to chest: 24"-54") 0 - 20 Lbs
      LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
      CARRY 1-handed, 0 - 20 pounds
      BEND FORWARD at waist
      KNEEL (on knees)
      STAND
      WALK - LEVEL SURFACE
      ROTATE TRUNK Standing
      REACH - Upward
      PUSH (0 - 20 pounds force)
      PULL (0 - 20 pounds force)
      SIT
      CARRY 2-handed, 0 - 20 pounds
      ROTATE TRUNK Sitting
      REACH - Forward
      MANUAL DEXTERITY Hands/wrists
      FINGER DEXTERITY
      PINCH Fingers
      GRASP Hand/Fist

About Samaritan Health Services

Samaritan Health Services is a not-for-profit network of hospitals, clinics and health services caring for more than 250,000 residents in the mid-Willamette Valley and central Oregon Coast. It is based in Corvallis, Oregon and has facilities in Albany, Lebanon, Newport, Lincoln City and Waldport. The health system includes five hospitals, more than 80 primary care and specialty clinics, senior living communities, and home health and hospice services. Samaritan Health Services is affiliated with the Oregon Health & Science University School of Medicine and is a partner in the OHSU Partners network. The health system is also a member of the Mayo Clinic Care Network.
Learn more about Samaritan Health Services
Size
5,500 employees
Industry
Healthcare
Founded
1970
* Ladders Estimates

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