Description

　　Providence is seeking a Clinical Editing System Program Manager:

　　The Clinical Editing System (CES) Program Manager is responsible for healthcare configuration solutions within PHP's core claims processing products (Optum CES, Facets, Networx, Optum Pricing).

　　This position functions as the primary point of contact between leadership, managers of supporting IS teams, project management, vendors, and is responsible communicating CES progress and status to executive leadership. This includes, strategic road mapping, identify financial opportunities, work prioritization, issue escalation through a governance process, and clear communication to all stakeholders regarding CES goals and workflows. Accountable for working with and facilitating processes to accomplish complex CES objectives, managing change and resolving issues that span across project teams and departments by planning, organizing, directing, and supervising program activities in a cost-effective and productive manner to achieve customer satisfaction.

　　A broad understanding of health plan wide processes, including claims processing, medical/coding policies, product implementations, provider network development and contract management is required. The ability to collaborate and communicate with our business partners is critical as we strive for alignment on intent, automation solutions and data accuracy. Analysis and continuous optimization of system functionality with focus on root cause analysis to ensure we are implementing long term data fixes is also key. May oversee team of up to 3-4 Caregivers.

　　In this position you will have the following responsibilities:

　　Manage CES goals in conjunction with business and IS objectives with increased complexity, strategic priority, system and/or other priority.

　　Continuously engages configuration team to organize the assignment of several initiatives, as well as project estimates, task dependencies and schedule.

　　Review quarterly KnowledgeBase for Managed Care Savings opportunities in order to align with our annual financial savings objectives.

　　Develops, initiates, and manages a communication plan, including regular program status reports through weekly leadership and monthly governance meetings.

　　Develop reporting and monitoring tools and ensure the team is following guidelines for documentation and resolution of issues within our internal change management system to support SLAs. Address trends, and training issues; responsible for monitoring SLA deficiencies across the assigned discipline.

　　Develop a yearly roadmap of resource needs and timing for KnowledgeBase, cumulative updates, upgrades, and projects.

　　Facilitates strategic planning with internal customers for deployment of information technologies and/or major services and products related to new growth and expansion efforts.

　　Evaluates best practice for optimal performance of CES to ensure objectives are met, including, health of CES like regular review of nonperforming edits and adopting new efficiencies with each KnowledgeBase.

　　Develops root-cause analysis and process improvement plans to support CES objectives.

　　Prepares and delivers presentations to senior and executive leadership, management, and stakeholders regarding all aspects of CES.

　　Develop reporting and monitoring tools and ensuring team is following guidelines for documentation and resolution of issues within our internal change management system to support SLAs.

　　Performs assessment of workflow processes, identifying gaps, escalating, and coordinating process solutions to both internal and external business partners to support best practice use of all information systems. Leads the team in removing barriers and addressing challenges and concerns.

　　Evaluates work performance and initiates personnel action such as interviewing, hiring, merit increases, promotions, transfers, and disciplinary action. Prepares annual and other written performance appraisals and development goals. Counsels Systems Administration in work-related issues and concerns. Promotes professional growth and development. Mediates problems and grievances.

　　Job Specific Knowledge, Skills and Abilities:

　　Skilled in strategic and tactical planning and program management - with demonstrated ability to quickly understand and align with an organization, its structure, and priorities. Ability to take initiative, prioritize work, manage time and respond effectively to a rapidly changing environment.

　　Superb written and oral communication that is excellent in the areas of timeliness, accuracy, professionalism (both interpersonally and technical).

　　Excellent interpersonal skills and the ability to work collaboratively with internal and external departments and vendors are required.

　　Proven ability to provide responsive leadership, delegation and coordination of day-to-day activities and project initiatives for a highly technical team.

　　Demonstrated ability to move ideas from concept to reality and inspire team through motivation and mentorship.

　　Ability to manage multiple and constantly changing projects and priorities and assist team members with priority setting. Ability to lead multiple projects and priorities.

　　Required qualifications:

　　Bachelor's Degree With 3 years related management/industry experience. OR

　　Associate's Degree With 5 years related management/industry experience. Or equivalent education/experience.

　　6 years related management or industry experience.

　　Preferred qualifications:

　　Supervisory/leadership experience.

　　Project management/implementation experience.

　　Why Join Providence?

　　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

　　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.

　　The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

　　Check out our benefits page for more information about our Benefits and Rewards.

　　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.

　　Providence is proud to be an Equal Opportunity Employer. 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 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. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

　　Requsition ID: 252152

　　Company: Providence Jobs

　　Job Category: IT Administration

　　Job Function: Information Technology

　　Job Schedule: Full time

　　Job Shift: Day

　　Career Track: Leadership

　　Department: 5018 OPS SYSTEM ADMINISTRATION OR REGION

　　Address: OR Beaverton 3601 SW Murray Blvd

　　Work Location: Murray Business Ctr Beaverton-Beaverton

　　Pay Range: $46.41 - $76.20

　　The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

　　Check out our benefits page for more information about our Benefits and Rewards.