community advocate

grants manager

care coordinator

program associate

director

Seattle-Indian-Health-Board

They created a position that had a title of "Compliance Manager", however they incorporated 3+ additional job responsibilities within the expectations of the title. 

I thought the title of Compliance Manager was to manage coders, audit physicians and help to upgrade their documentation, which is what a "compliance manager" under these circumstances does. 

While interviewing they told me there would be billing manager responsibility as well. That can be difficult because coding rules are different from billing rules.  They also padded on the responsibility of credentialing providers with insurance companies.  If you take the duties of these 3 titles, that's 3 FULL TIME jobs, however they expected 1 person to execute them all with proficiency.  Not to mention I was to manage the implementation of a new billing system from ALLSCRIPTS, which was a total disaster!!! Since Allscripts sold us a product and then left SIHB without a lifeline with their offshoot revenue cycle company CHMB.

Additionally, SIHB is going through a redefinition itself from an FQHC that relies on grants and government funding to a clinic that relies on Medicare/Medicaid and third party billing (as it should).  However, NO ONE IN THE ORGANIZATION HAD ANY IDEA HOW TO MASTER THAT TYPE OF BILLING!!!

As the manager of this mess, I never had the opportunity to implement the auditing and education models for providers which I excel in.  I did make improvements in staff confidence and elevating their knowledge of the revenue cycle. I made improvements in communication between departments and processes.  There was so much more I wanted to do.  However there is a culture there that allows ppl to stay who have seniority in years vs. those working hard to bring make organization a premier clinic for all patients and residents of the Puget Sound region.

 - The physical work environment (sitting behind a desk for 10 hours, staring at a screen in a space with no windows) did not align with me and caused me severe emotional, mental, and physical distress. 
- The lack of direct service work was not what I was looking for and I felt that I had strengths that are not being utilized.  
- The strictness on PTO and hours did not align with my personal values surrounding wellness and putting yourself first. I did not expect that there would be this much strictness within this Indigenous-led organization. Having this much strictness on PTO made me feel like I could not take a day for myself when I needed it for my mental health. People would come to work sick all the time and COVID spread quickly.  - I frequently felt like my time was not valued, and that I was expected to hold work above myself, which does not align with my personal values.  
- I’m having a difficult time supporting myself financially. The pay is absurd. 
 - Although I’ve made great connections with people here, I do feel like there is a competitive work environment that does not serve my greater purpose or my mental health. I am in a place in my life where I want to cultivate more joy and more experiences after going through a lot, and I feel that this work environment does get in the way of that. Like I’ve heard people brag on multiple occasions, about not taking breaks or lunch and I feel that putting any workspace above yourself is inherently toxic, and does not align with me.
Advice to Management
Don’t treat lower program team like we’re inferior. There are severe, strict hierarchal structures present within this organization.

A typical workday is different for every position but for myself it consisted of meetings and assignments given directly by the CEO. I learned that not all leaders are ready to lead and not all followers believe in the vision of their leaders. Management was kind but has an impulsive head with sensitivities that result in ultimatums. The ground staff expressed distanced interest to the leaders’ overall vision but does their best with what is provided. The hardest part of the job is being trauma dumped on and not having space to manage that or express those impacts. It’s also difficult if you’re a person of visible color as the company asks external facing positions to assimilate to white republican presentations for the sake of funding. The ground work people and those truly in the medicine of this place are so lovely. Everyone here is truly trying their best to provide care to those in their communities. Their biggest thing seems to be how community is defined and how do we get taken  care of as the workers in this community.

I feel like you don't get proper pay for the amount of work that you do you have to ask for your raise so sometimes your work feels like it goes unnoticed sometimes it feels like the place is full of cricket people and they do lay people off the higher up managers stay in their office and only come out when they come out to grill you about something that needs to be donebut never want to come out their offices to figure out better ways to keep the facility going smoothly and when you do stand up for something you have a chance of being fired for saying what's on your mindbecause they don't understand that you're the one that is actually out there with the patients and what you see daily while they're sitting in their office wondering why the facility is not running smoothly and properly like it should be they say that they're all about mental illness and helping people with trauma but working there gives you because everything that goes on in that place. just a whole bunch of lies

As a previous provider with the Seattle Indian Health Board, I feel it’s important to share an honest account of my experience. While the organization has a meaningful mission and serves a community I care deeply about, the day-to-day work environment was extremely challenging. The clinic often felt chaotic, disorganized, and outdated. Instead of focusing on stabilizing and improving the functioning of the main clinic, leadership seemed more focused on rapidly expanding and opening new sites. This left existing staff struggling without the basic support needed to provide safe and consistent patient care. We were frequently short on medical assistants and nurses, and the turnover rate across the clinic was concerning. What was most discouraging was the lack of attention given to understanding why so many staff were leaving and what could be done to address it. As a provider, I did not feel heard or valued by the executive team. My concerns and recommendations were often brushed aside, and there was very little effort to engage frontline clinicians in decision-making.

I had so much hope and excitement when I started at SIHB. However, it became clear that nepotism and favoritism is how you survive. It's very concerning behavior from the C-Suite and the Board of Directors doesn't seem to care. 

-Absolute authoritarianism without accountability (CEO and C-suite is very reactionary and make changes frequently)
-Zero tolerance for criticism or questions (despite saying they're open door and want questions, the questions are turned around on you like, "Why do you need to know this?" "Why are you friends with this person? "Why don't you care about Native people?")
-Left feeling like you're never able to be “good enough”
-C-suite never allows for communication/acknowledgment when folks leave. A belief is that former employees are always wrong for leaving (unless it's for school) and there is never a legitimate reason for anyone else to leave.

Working at Seattle Indian Health Board was deeply disappointing. Leadership often prioritizes media coverage, public appearances, and reputation-building over the well-being of patients, staff, and community members. The environment can feel toxic, with management fostering a culture where distrust and low morale are common.

While there are many incredible and dedicated staff members who care deeply about the mission, their efforts are frequently undermined by organizational dynamics at the top. Instead of focusing on supporting employees or strengthening community health, too much energy is directed toward appearances and narratives that serve leadership’s image.

Until there is meaningful change in leadership culture, it will be very difficult for this organization to truly live up to its stated mission of serving the Native community

The services provided to Relatives (patients) are amazing. The teams providing care to the patients truly care, and they are excellent at their job. My coworkers were amazing and I enjoyed working with them. I was so excited to start working here, but quickly realized I was presented an organization through rose colored glass. The problem I kept running into was how chaotically ran the organization was from the upper management level. It would take months to get basic supplies. No matter how hard the patient facing and medical team worked, things would still fall through the cracks because of the lack of structure created by upper management. I was incredibly let down in what this organization ended up being. I truly hope some changes can be made to provide the care and environment staff and patients deserve. 

Working here was one of the worst professional experiences I have had. The environment was extremely mentally draining, and the overall culture felt unhealthy, frustrating, and unsupported.

Executive leadership was rarely present or meaningfully involved, and many managers and directors appeared ineffective, disconnected, or out of touch with the realities employees were dealing with. There was a noticeable lack of accountability, communication, and competent decision-making.

There also appeared to be clear favoritism in promotions and leadership opportunities, which made it difficult to believe that growth or advancement was based on fairness or merit.

Based on my experience, I would not recommend this employer to anyone looking for strong leadership, transparency, fairness, or a positive work environment.

Amazing patients and meaningful work. I like my team and my boss. I like working with people who look like me. Generous 401k. However, there is a top down leadership mentality, which is problematic because the executive team does not have a doctor or nurse among them. They say they run the business like a start-up, without realizing that for most workers this has a negative connotation. Workers are scheduled for 11-hour days with an unpaid lunch, then meetings are scheduled AT LUNCH. Vicarious trauma and burnout are rife here. When people finally leave there is no effort to transfer knowledge and the next person starts from scratch. High turnover all the way up to the executive level.

Top Job Titles	Average Salary
Community advocate 2 salaries reported	$21.32 per hour
Grants manager 4 salaries reported	$79,369 per year
Care coordinator 3 salaries reported	$24.00 per hour
Program associate 3 salaries reported	$23.50 per hour
Director 3 salaries reported	$115,502 per year

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