SAIF leads the industry because of innovation that has helped make Oregon one of the safest places to work. But no matter how hard we try to keep Oregon workers injury-free, sometimes someone gets hurt. When that happens, we want that person to have the best possible medical care.
Our medical programs team ensures quality care and fair medical costs by using their knowledge and expertise to respond to injuries; anticipate needs; and support recovery, people, and employers. Leading that team requires a person who is not only passionate about patient outcomes, but can analyze and stay on top of the latest trends in patient care, medical treatment, and costs.
You will advance the integration of medical services into our claim management by supporting our nurse consultants, who guide and educate SAIF claims adjusters on the medical aspects of injuries. You will oversee the operations of our medical audit review section (MARS) who reviews medical bills to ensure proper payment for services. You will help continue to improve our work by collaborating with regulatory agencies, managed care organizations, medical providers, and vendors.
So, if you have at least eight years’ experience in acute care medicine or health administration, along with significant experience supervising staff or managing programs through analysis and interpretation of medical or claims data, we invite you to consider this opportunity at SAIF. Although not required, it’s a plus if you have a current RN license and your experience includes working with regulatory agencies, medical providers, and negotiating and managing vendor contracts.
- Design, develop, and communicate annual strategies, goals, initiatives, and indicators of success for medical programs and integrated services. Ensure plans are developed in collaboration with the claims management team and corporate leadership.
- Anticipate contract and program needs, negotiate and procure contracts with medical service providers, and evaluate contractor performance.
- Manage staff by utilizing the performance management process, clarifying job responsibilities and performance expectations, establishing goals and job competencies, identifying skill gaps, creating development plans, coaching on a continuous basis, and evaluating performance. Responsible for the hiring and termination of employees and determining wage/salary levels within SAIF policy guidelines.
- Provide analysis and guidance on staffing and organization structures, processes, and workload management. Research, propose, plan, and implement organizational changes, innovative methods, tools, and training as required to ensure program quality, efficiency, and effectiveness.
- Function as the primary liaison with SAIF management, regulatory agencies, and internal and external business partners for the effective integration and ongoing success of medical programs.
- Stay abreast of medical and cost trends and drivers to provide updates to internal business partners on the potential impact of increased medical care costs.
- Assist with the preparation of the operational budget, monitor expenditures throughout the year, and manage variances to ensure budgetary guidelines are met while upholding high standards of customer service excellence.
- Provide program status updates to communicate program successes and completion of goals.
The following qualifications are recommended:
Eight or more years of experience in medical program management, healthcare administration, acute care medicine, or a related field.
Three years of supervisory or significant leadership experience.
Experience with data and the ability to analyze trends.
A bachelor’s degree in nursing, healthcare administration, or a related field
Other combinations of education and experience demonstrating the knowledge, skills, and abilities required to perform the job will also be considered.
To receive consideration, please submit your SAIF Application for Employment by the close of this recruitment. We want your application to count, so be sure it’s complete and that you submit all the required materials.
This recruitment will close at 5:00 p.m. on Monday, October 9, 2017.
If enough qualified applications are received this recruitment may close early.
Qualifying veterans and disabled veterans may obtain preference in employment by submitting the following documentation as verification of eligibility:
A copy of the Certificate of Release or Discharge from Active Duty (DD Form 214 or 215), or
A letter from the U.S. Department of Veterans Affairs indicating receipt of a nonservice connected pension.
Disabled veterans also must submit a copy of their veteran’s disability preference letter from the Department of Veterans Affairs, unless the information is included in the DD Form 214 or 215.
To be considered for preference, you must submit the proper documentation to moc.fiasnull@sboj before the application deadline.
SAIF Corporation is Oregon’s not-for-profit, state-chartered workers’ compensation insurance company. SAIF has been doing business for more than 100 years and is the leading workers’ compensation insurance provider in Oregon.
Learn more about the opportunities and benefits of working at SAIF. Visit our website or see our Facebook page.
SAIF is an Equal Opportunity Employer that values diversity in its workplace.
To apply for this job please visit the following URL: https://jobs-saif.icims.com/jobs/2198/medical-programs-manager/job →