Ronald Harris, Jr. is giving the care his patients need … from the fourth floor of his downtown Portland, Oregon apartment.
The 2016 BSN graduate serves as a “utilization management nurse” in the Provider Reconsideration department for Providence Health Plan (PHP), the nonprofit insurance arm of Providence Health & Services that is located in 7 states and is one of the larger health systems in the area. Harris uses his nursing background to examine a patient’s case either as a prior authorization (PA) or a claim (services already provided) to advocate for those services that have been previously denied and can be reviewed for an Overturn at the RN level or send to the Medical Director to review.
“When something gets denied originally — let's say if it's imaging — then it comes to my department. Then, we can look at it again to see if we can overturn it.”
It’s not unusual for Harris to look at 10 or more cases in a day in Provider Reconsideration, including some busy days where he might review upwards of 30 claims where he is cross-trained. Every situation is unique, including one he recalled where a patient was denied access to a type of Insulin pump.
“I had access to case management notes,” Harris said. “I was able to get a full picture and really try to advocate for this member, and I was able to get it approved for them. The pump wasn't efficient for them to manage their diabetes, and they needed to switch to a more aggressive pump.”
Harris finds his current job fulfilling, but notes it was a difficult journey getting to where he is today. The summer before he was supposed to start the nursing program at MSU in the fall, a car hit him near campus, breaking his leg. Since students are required to do clinical rotations as part of their program, Harris also could not be on painkillers, and said he had to rely on Tylenol and “deep breathing.”
Thankfully, Harris quickly found a community, becoming a part of the College of Nursing’s Achieving Culturally Competent Education and Student Success (ACCESS) program. The program provides financial and educational support to students from disadvantaged backgrounds.
“If it wasn't for that program, I would not be a nurse right now,” said Harris, a first-generation student. “We would have presenters, and it was just, like, this is the most diversity we have seen at Michigan State. We really did form a tight-knit group there.”
During his time at MSU, Harris made it a point to travel, going on the college’s “Nursing in London” study abroad and “Nicaragua: Rainforest and Reality” within his freshman year at MSU. He also visited Australia, Brazil and Mexico. He felt it important to learn about the world and different cultures before transitioning into working life. His nursing courses also introduced him to informatics, which eventually led to Harris earning a Master’s in Nursing Informatics from Capella University.
Following graduation, Harris took more traditional nursing positions in hospitals in Minnesota and then Portland, before moving into his current role in 2023. Harris said he had some negative interactions with patients who made his race and gender an issue, when he was more than qualified to provide treatment.
That’s one reason he is active in supporting nurses of color, including serving as a member of the Alliance of Black Nurses Association of Oregon (ABNAO), which meets regularly, as well as speaking at Portland-area schools. Harris noted Black nurses only make up about 1.4% of the nursing workforce in Oregon.
“I know the challenges that we have, and I know how it actually is in practice, especially when you are Black or of color in some way,” Harris said. “So, I try to support people as much as I can. You know, it's not easy. I did not get here by myself. I had people that helped me, that believed in me, that supported me, and I try to do that for others.”
Harris has also become involved in his community outside of nursing, including joining a book club that meets at a local Black-owned business.
“I feel like I'm just now starting to find people to connect with, and, you know, build that community,” he said.
Portland became home when Harris wanted to move to a more temperate climate, with good public transit, a healthy mix of outdoor activities and urban amenities and a thriving concert scene. Harris said he had to remain strong in his choice, as all his family is from Michigan.
“You can't be afraid,” he said. “You just have to leap and go. If the opportunity arises … create a plan for yourself and execute it. What does peace look like for you? For me, the moment I'm in right now, I feel safe, seen and appreciated at work (in ways) I feel like I have never had in my career.”
