Role Description The Utilization Management Nurses work within the multidisciplinary team to determine medical necessity of admission and continued stay in the hospital as well as correct patient classification and efficient use of resources. They conduct robust utilization review using established criteria to determine appropriateness of admission and continued stay and work with payers to assure ongoing authorization for continued stay. They contribute to meeting OHSU’s strategic plan of safe LOS reduction and reduction in readmission rates. - Reviews pre-admissions for correct classification and admission order. - Performs Utilization Review for each patient on their assigned daily census using established medical necessity guidelines. - Communicates with payers regarding authorization and medical necessity, utilizing excellent negotiating skills. - Reviews order/classification discrepancies and takes actions to resolve the discrepancy. - Discusses cases with providers and Case Managers as needed, including attending physicians and escalation to the Care Management Physician Advisor when indicated. - Assesses for and tracks potentially avoidable hospital days. - Assesses for and records reasons for readmissions. - Participates in and supports strategic initiatives to reduce readmissions and LOS. - Attends and contributes to Outlier Review rounds on an ad hoc basis. - Provides education regarding Utilization Management issues to the Multidisciplinary team. - Prepares and conducts presentations, as assigned, to their assigned physician groups regarding issues related to Utilization Management in conjunction with the Care Management Physician Advisor. - Educates providers regarding documentation requirements that support medical necessity determinations. - Prepares and presents reports as requested by UM Management. - Facilitates MD Advisor to payer discussions. - Assesses whether there is a basis for written appeal for cases in which payment is denied due to medical necessity concerns. - Composes persuasive and grammatically correct written appeals for claims denied by payers for lack of medical necessity. - Presents Case Studies illustrating systems issues that adversely affect LOS and/or readmission rates to the Clinical Resource Management Committee and the Care Management Department. - Serves as a member of department and/or hospital committees and task forces working on issues related to Utilization Management, as assigned. - Delivers Condition Code 44 notices, Observation notices (MOON), and Medicare Important Messages (IMM) in the absence of sufficient clerical support. - Educates patients about their classification and financial implications as needed. - Communicates in writing with attending physicians about UR Committee cases. - Facilitates Utilization Review case reviews in accordance with Medicare Conditions of Participation: Utilization Review. - Coordinates and processes Medicare discharge appeals along with clerical support. - Conducts secondary reviews for peers, assessing appropriate classification and medical necessity. - Communicates closely with the multidisciplinary team about patients’ expected hospital course, expected discharge date, GMLOS, and authorization status. - Communicates status upgrades and downgrades with the Bed Flow Manager. - Documents according to departmental policy. - Works with coding, patient business services, surgery schedulers, registration, and integrity department to determine correct billing and coding status for complex cases and assure correct classification. - Provides feedback to managed care contracting regarding insurance company billing policies and practices that adversely affect OHSU’s ability to collect proper reimbursement for care provided. - Leads the effort to assure compliance with CMS and other insurance regulations related to Utilization Review. - Maintains current knowledge of, and complies with regulatory requirements of DNV, Medicaid, Medicare, CMS, applicable state regulations and Oregon Nurse Practice Act. - Other UM activities as assigned. Qualifications - Three years of UM/UR experience required. - BSN Graduates: Baccalaureate Degree in Nursing from a program accredited by CCNE, ACEN, or CNEA 30 days before start date. - ADN Graduates: Associate Degree in Nursing from an accredited program 30 days before the start date. - Associate degree Nurses required to enroll in BSN program within 3 years of hire and complete within 5 years of hire. - Current, unencumbered Oregon State Registered Nurse License. - BLS from AHA required. New hires will be enrolled and required to complete during orientation. - Must be able to perform the essential functions of the position with or without accommodation. Preferred Qualifications - Case Management Certification (ACM-RN, RN-BC, CCM, CGS, etc) preferred. - Knowledge of MCG, Indicia guidelines preferred. Benefits - Comprehensive health care plans covered at 100% of the cost for full-time employees and 88% for dependents. - $50K of term life insurance provided at no cost to the employee. - Two separate above-market pension plans to choose from. - Vacation: 192 to 288 hours per year depending on length of service, prorated for part-time. - Holidays: up to 64 holiday hours per calendar year. - Sick Leave: 96 hours per year, prorated for part-time. - Substantial public transportation discounts (Tri-met and C-Tran). - Tuition Reimbursement. - Innovative Employee Assistance Program (EAP) including extensive wellness resources.

• Develop, execute, and measure results of sales strategies to achieve revenue, traffic, and profitability targets • Ensure alignment with target budget plan and new product distribution goals • Oversee relationship with both Amazon and agency partners • Collaborate cross-functionally with internal teams like digital media, creative, and finance • Identify trends and new opportunities for revenue and category growth

Role Description The Senior Manager, Oracle Fusion Technical Delivery is responsible for leading the end-to-end delivery of Oracle Fusion Cloud initiatives as the organization transitions from legacy platforms. This role ensures successful planning, execution, and delivery across multiple workstreams, aligned to business priorities and strategic objectives. - Serves as a technical delivery leader, providing expertise in solution architecture, integrations, and data migration. - Drives execution discipline across all phases of the program lifecycle. - Ensures alignment across business stakeholders, IT teams, and implementation partners. - Enables high-quality, on-time, and within-scope delivery. - Provides leadership, mentorship, and governance over delivery teams and vendors. - Supports continuous improvement and maximizes business value from the organization’s Oracle Fusion Cloud investment. Qualifications - Proven experience in managing Oracle Fusion Cloud initiatives. - Strong technical knowledge in solution architecture and integrations. - Leadership and mentorship experience in a technical delivery environment. - Ability to align multiple stakeholders and manage cross-functional teams. Requirements - Experience in project management and delivery methodologies. - Excellent communication and interpersonal skills. - Strong analytical and problem-solving abilities. - Ability to work in a fast-paced environment and manage multiple priorities. Benefits - Competitive salary and performance-based incentives. - Comprehensive health and wellness benefits. - Opportunities for professional development and career advancement. - Employee discounts and perks.

• Assess internal and external risks and opportunities. • Analyze and synthesize data to develop clear recommendations. • Collaborate with the Strategy team and leaders. • Scope and plan projects ensuring clarity at the start. • Lead and support projects driving performance.