7 jobs found

Quantum Health seeks a Medical Director Utilization Management to lead clinical strategy for its healthcare navigation and care coordination programs. In this role, you'll design and oversee evidence-based utilization management policies, guide complex case review, and ensure appropriate, cost effective care. You'll partner with analytics, tech, and clinical teams to interpret data, improve outcomes, and support regulatory compliance. Working in a collaborative, mission driven culture, you'll mentor clinicians, influence product innovation, and help transform the consumer healthcare experience. Responsibilities Lead clinical strategy for utilization management across Quantum Health programs Develop, implement, and oversee evidence-based medical necessity and utilization policies Review complex or escalated clinical cases and make coverage determinations Partner with data and analytics teams to monitor trends, costs, and quality outcomes Collaborate with provider networks,...

Olympus Health coordinates and performs physical evaluations for state agencies supporting individuals applying for government services in Oregon and multiple other states around the country. We provide this service one or two Saturdays per month, ensuring there is no conflict with your current professional schedule. Each clinic day typically runs from 9:00 am to 5:00 pm, depending on the number of scheduled evaluations. PERTINENT INFORMATION As the provider, you will provide disability examinations and evaluations that primarily test the claimant s function and range of motion. Conduct basic physical evaluations using a structured, easy to follow template Perform assessments solely for the purpose of assisting the State of Oregon in determining eligibility for government programs Document findings clearly and professionally Not establish a doctor patient relationship Not provide diagnosis, treatment, or medical advice Not determine whether a...

Fora Health Inc, a nonprofit addiction treatment and mental health provider in Portland, OR, seeks an LPN or RN for our Withdrawal Management unit. In this onsite role, you'll deliver trauma-informed, evidence-based nursing care to patients undergoing detox, including assessment, monitoring, medication administration, and crisis response. You'll collaborate closely with an interdisciplinary team, support patient and family education, ensure accurate documentation, and uphold safety and regulatory standards in a compassionate, recovery-focused environment. Responsibilities Provide 24/7 nursing care for patients undergoing withdrawal management Assess, monitor, and document vital signs, symptoms, and withdrawal severity Administer medications and treatments per protocols and provider orders Respond to medical and psychiatric emergencies and escalate as needed Educate patients and families on withdrawal, medications, and recovery resources Collaborate with physicians,...

Olympus Health coordinates and performs disability determination physicals for various local and governmental agencies such as Medicare and the Social Security Administration in Oregon and multiple other states around the country. We provide this service in the area 1-2 days per month, on Saturdays, so you don t need to be concerned about conflicts to your personal or professional time elsewhere! Generally, each clinic (depending on the number of patients scheduled) will be scheduled from 9:00 am to 5:00 pm. PERTINENT INFORMATION As the provider, you will provide disability examinations and evaluations that primarily test the claimant s function and range of motion. The evaluation you will perform will be solely in connection with the determination of the patient s entitlement to Social Security disability or Medicaid benefits. You will not be establishing a doctor-patient relationship nor be providing any diagnosis, advice, or treatment to the claimants, nor will you...

Summary JOB SUMMARY/PURPOSE Directs the management of ambulatory nursing operations and the clinical practice of the ambulatory primary, specialty, and urgent care clinics in partnership with AVP- Operations and Senior Medical Directors. Oversees regulatory and safety activities. Develops improvement strategies by identifying and evaluating trends, needs, forecasts and established measurements to provider quality care. Designs programs and procedures, resolves issues, and implements change. Provides programmatic leadership and direction for the continuum-based operating model for care management and care coordination services for SMG. DEPARTMENT DESCRIPTION The Clinic Administration teams at Samaritan Health Services are committed to providing leadership and operational support for our physicians, advanced practice clinicians and all other employees that deliver care in our clinic practices....

Summary JOB SUMMARY/PURPOSE Directs the management of ambulatory nursing operations and the clinical practice of the ambulatory primary, specialty, and urgent care clinics in partnership with AVP- Operations and Senior Medical Directors. Oversees regulatory and safety activities. Develops improvement strategies by identifying and evaluating trends, needs, forecasts and established measurements to provider quality care. Designs programs and procedures, resolves issues, and implements change. Provides programmatic leadership and direction for the continuum-based operating model for care management and care coordination services for SMG. DEPARTMENT DESCRIPTION The Clinic Administration teams at Samaritan Health Services are committed to providing leadership and operational support for our physicians, advanced practice clinicians and all other employees that deliver care in our clinic practices....

Summary JOB SUMMARY/PURPOSE Directs the management of ambulatory nursing operations and the clinical practice of the ambulatory primary, specialty, and urgent care clinics in partnership with AVP- Operations and Senior Medical Directors. Oversees regulatory and safety activities. Develops improvement strategies by identifying and evaluating trends, needs, forecasts and established measurements to provider quality care. Designs programs and procedures, resolves issues, and implements change. Provides programmatic leadership and direction for the continuum-based operating model for care management and care coordination services for SMG. DEPARTMENT DESCRIPTION The Clinic Administration teams at Samaritan Health Services are committed to providing leadership and operational support for our physicians, advanced practice clinicians and all other employees that deliver care in our clinic practices....