Providence Health & Services PHC Bundle Care Program Manager in Spokane, Washington
Providence is calling a PHC Bundle Care Program Manager (Clinical Effectiveness, Days, 1.0 FTE, Full-Time, Salaried) to Providence Health Care Region in Spokane, Washington. We are a community of caregivers delivering every day on our Mission to provide compassionate care that is accessible for all - especially those who are poor and vulnerable.
The primary responsibility of the PHC Bundle Care Program Manager is to guide and coordinate high and rising risk patients through multiple care delivery systems, from the identification of surgical/procedural patients through the ninety day episodes of care. The Bundled Payments Care Program Manager leads all aspects of the bundled patient throughput to achieve organizational goals through standardized processes developed in conjunction with clinical leadership. Patient populations may include current CMS Bundles (e.g. BPCI-Advanced), Commercial Bundles (e.g. Premera Total Joint Replacement) and future payor bundles mandated by CMS.
Apply Today! Applicants that meet qualifications will receive a text with some additional questions from our Modern system.
In this position you will:
Maintain and report an accurate census of bundled patients. Lead teams to gather clinical information from the EMR, telephonic health assessments, and home visits as applicable to determine risk stratification. This includes a comprehensive assessment of physical, emotional, psychosocial, and environmental needs of the patient.
Build a collegial working relationship to efficiently manage the bundled patient across the health care continuum to manage length of stay and discharge disposition, reinforcing that the patient is in the right environment at the right time; asks questions and influences decision points as needed to provide the patient with the most appropriate site of care for transition.
Lead the self-management action plan of care, coordinates services that navigates patients through the health care system with a goal of enabling the patient and family to effectively manage their condition(s) and optimize optimal health outcomes.
Collaborate with multidisciplinary team members in the acute, post-acute and outpatient settings to identify patient needs such as home health care, DME, physical therapy and community services.
Coordinate effective transitions of care and effective handoffs to the next level of care across the entire continuum. Perform outreach to SNFs, Rehab, and Home Health to ensure patient needs and key metrics are being met.
Follow up with patients at pre-determined intervals and as needed based on patient status (in person or by telephone). Communicate with patient’s care team including but not limited to hospital team, surgeon, and primary care physician.
Maintain required medical documentation for care management activities in the system's care management module (electronic medical records), according to the standards of work.
Identify gaps or barriers in treatment plans to ensure that discharged patients receive appropriate resources and services.
Maintain awareness of key performance indicators/metrics and manages caseload through appropriate management of medical expenses. Coordinate interventions to prevent adverse events such as ED visits, hospital admissions, and readmissions.
Attend Bundled Payments work group meetings to report on success of program initiatives and processes.
Act as a patient advocate and support to patients and families of the related programs.
Remain flexible and responsive when changes occur in patient activity and workload.
Required qualifications for this position include:
5 years of experience and in-depth knowledge of care management and care coordination, current standards of inpatient and post acute care, chronic disease management and surgical care.
3 years of professional communication skills needed for all clinical interactions as well as excellent interpersonal skills/techniques needed to promote patient, family and caregiver involvement.
3 years of strong attention to detail. Track record of success in the coordination of patient care across multiple sites.
Preferred qualifications for this position include:
Master's Degree in Nursing or related degree
3 years of Case management and/or utilization management experience.
3 years of Healthcare experience.
2 years of Social work or case management experience.
2 years of Lean Six Sigma or project management experience.
About the hospitals and clinics you will serve.
Providence Health Care has a commanding presence in Eastern Washington. We offer a full range of medical and surgical services as well as specialty support and outpatient services for adults and children. Our providers and staff strive to create a distinctive health care experience for each patient- one focused on trust, respect, communication and teamwork.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate 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.
Job Category: Project & Program Management (Non-Clinical)
Req ID: 302601