Utilization Management Auditor Jobs in Oregon (NOW HIRING)

JOB SUMMARY:The Clinic Manager oversees the clinical and non-clinical administrative functions at Newberg, including departmental planning related to staffing, scheduling, and budget; implementing appropriate systems and processes for the efficient delivery of care; and ensuring safe, high-quality care and an outstanding experience for patients and their families. This leadership role assumes responsibility for managerial functions in the clinical and non-clinical setting, including maintaining effective interprofessional communication and a positive work environment that supports and embraces the principles of the organization. The Clinic Manager ensures that staff is educated and competent to care for the patients under their care and works effectively with physicians, peers, and other leadership to meet the organization's strategic objectives. MAJOR RESPONSIBILTIES:Clinical and Front End Practice: The Clinic Manager coordinates, manages and directly oversee's the clinicial and support staff workflows within the clinic. This position functions as an integral member of the clinic leadership team overseeing the care provided by both the clinical and Front desk teams and initiating efforts to improve the quality and skill levels of the all staff members within the site. Leads clinical and non-clinicial staff to ensure that patient care services are provided in an efficient, safe, and timely manner that is sensitive to the patient's physical, psychological and spiritual needs. Ensures compliance with established clinic policies and procedures. Creates, amends, and evaluates policies and procedures as delegated in conjunction with clinical and non-clinicial practices at the site. The Clinic Manager will collaborate closely with the Practice Managers to oversee the front desk team, ensuring seamless coordination of overlapping projects, processes, training, hiring, and performance evaluations, all aimed at maintaining the highest standards of work. Additionally, the Clinic Manager will monitor and develop reporting for site meetings on key clinical metrics, including referral metrics, phone access, patient appointment scheduling, availability, and appointment utilization, to ensure compliance with organizational and customer service standards. Ensure close oversight of front end operations, scheduling and collection of payments, including scripting/auditing to ensure we are providing a great customer service experience, while reducing avoidable adjustments caused by the front-end work processes.Training: Develop, maintain, and present training programs ensuring all team members at the site are effectivity trained and proficient in their roles. Create and manage a centralized electronic system of reference tools and training materials offering standardized materials. Directs the development of competencies so staff achieves maximum performance capacity. Ensure regulatory compliance with all state and federal guidelines and other accrediting entities while identifying ongoing training needs for all team members at the site working in conjunction with the Tualatin Practice Manger for the front desk team. Ensures staff has the knowledge and skills to provide appropriate, safe care to patients and families through education, coaching, training, or experience. Maintains and ensures the front deak lead's are trained to support everyday tasks. Quality Improvement: Facilitates the organization's performance improvement program and goals in conjunction with leadership teams. Develops, implements, and maintains quality monitoring processes. Formulates module goals that are reflective of measurable objectives and evidence-based practice. Develops team goals and quality management plans responsive to the changing healthcare needs of the patients.Leadership: Designs a staffing plan to meet the needs of the patients being served and ensures appropriate allocation of resources to meet departmental needs. Monitors performance of staff and departmental processes. Provides guidance and performance feedback regularly. Proactively follows-up on future plans for action. Creates and maintains a positive work environment that supports a culture of shared decision-making and open communication. Develops the departmental budget; makes decisions regarding expenditures of funds to meet department objectives and maintains costs within budgeted amounts. Develop standards of practice including emergency and safety standards in conjunction with the Safety and Compliance Officer and committee's. JOB REQUIREMENTS:Education/Work Experience/ Licenses & CertificationsA degree from an accredited nursing program, Bachelor of Science in Nursing (BSN) preferred, and an active State of Oregon LPN or RN license with minimum three (3) years of clinical experience as a RN or LPN and a minimum of (2) years management experience in the healthcare field, OR High school diploma or equivalent with a Certified Medical Assistant Diploma and active State of Oregon Medical Assistant Certification, plus a minimum of (4) years of supervisory experience in a healthcare setting. Team Lead, or other like position may be accepted in lieu of 1 year formal supervisory experience.CPR and Basic Life Support (BLS) for Health Care Providers is requiredRequired Skills, Knowledge, and AbilitiesDemonstrated understanding of clinical and operational processes, staff licensure/certification, clinical competency requirements, and scope of practice concepts.Ability to performance manage, coach, and develop staff.Ability to lead and implement change management and process improvement activities. Immunizations are a requirement for employment to help ensure a safe and healthy workplace by reducing the risk of communicable diseases. TCC requires proof of vaccination including MMR, Hepatitis B, Tdap, Varicella, Influenza, and TB Screening.