1

Health Plan Jobs in Remote, OR (NOW HIRING)

Be Seen First

This role involves assessing inpatient admission and continued stays, coordinating with healthcare providers, facilitating communication with payers, and ensuring compliance with health plan policies ...

UM Nurse

OR · Remote

Review cases for medical necessity and apply the appropriate clinical criteria; to include, but not limited to Medicare criteria, Medicaid/Medi-cal criteria, Interqual, Milliman, or Health Plan ...

next page

Showing results 1-20

Health Plan information

What is a health plan?

A health plan is a type of insurance that helps cover the cost of medical and health-related expenses. It typically provides benefits for doctor visits, hospital stays, preventive care, prescription drugs, and sometimes dental and vision care. Health plans can be offered by private companies, employers, or government programs, and may vary in terms of coverage, networks, and out-of-pocket costs. Choosing the right health plan depends on your healthcare needs and financial situation.

What are the key skills and qualifications needed to thrive as a health plan manager, and why are they important?

To thrive as a Health Plan Manager, you need a strong background in healthcare administration, insurance regulations, and policy analysis, typically supported by a bachelor's or master's degree in health administration or a related field. Familiarity with healthcare management software, claims processing systems, and regulatory compliance tools is essential. Exceptional communication, leadership, and problem-solving skills help navigate complex stakeholder relationships and drive organizational goals. These skills and qualities are vital for ensuring operational efficiency, compliance, and member satisfaction within a competitive healthcare environment.

What are some common challenges faced by professionals working in health plan administration, and how can they be effectively managed?

Professionals in health plan administration often encounter challenges such as keeping up with frequently changing healthcare regulations, managing complex claims processes, and ensuring seamless coordination across multiple departments. Staying updated on compliance requirements and investing in ongoing training can help mitigate risks. Effective communication and collaboration with colleagues in customer service, underwriting, and IT are also crucial for addressing issues quickly and maintaining a high standard of service for plan members.

What is the difference between Health Plan vs Health Insurance Coordinator?

AspectHealth PlanHealth Insurance Coordinator
CredentialsVaries; often includes insurance or healthcare administration certificationsTypically requires insurance licensing or certification
Work EnvironmentInsurance companies, healthcare organizations, government agenciesInsurance companies, healthcare providers, broker offices
Employer & Industry UsageUsed by organizations managing healthcare benefitsUsed by insurance firms coordinating policies and claims
Search & Comparison IntentUnderstanding healthcare benefit options and plansManaging and coordinating insurance policies and claims

While both roles relate to healthcare coverage, a Health Plan typically refers to the actual healthcare benefits or coverage options provided by insurers or employers. In contrast, a Health Insurance Coordinator focuses on managing, processing, and coordinating insurance policies and claims within organizations. Understanding these differences helps clarify career paths and job functions in the healthcare industry.

Infographic showing various Health Plan job openings in Remote, OR as of August 2026, with employment types broken down into 2% As Needed, 77% Full Time, 14% Part Time, and 7% Contract. Highlights an 80% Physical, 1% Hybrid, and 19% Remote job distribution.

Healthcare HEDIS/Quality Operations Coordinator

Roseburg, OR


P3 Health Partners
Health Care and Social Assistance • 51 - 200 employees

6.6

Company rating: 6.6 out of 10

Based on 5 frontline employees who took The Breakroom Quiz


$22 - $28/hr

Full-time

Posted 13 days ago


Job description

Overall Purpose

The Regional Quality Coordinator role is responsible of managing Quality operational support initiatives while overseeing special projects, with a focus on supporting HEDIS and Pharmacy gap closures. This position requires daily problem-solving, meticulous tracking, and coordination across departments to meet varying and changing requirements. The RQC will oversee assigned affiliate groups, providing Quality operational support to clinics to achieve their goals, which may include engaging with internal and external stakeholders with in-person and telephonic outreach to patients for education and engagement on preventative screenings, data mining, medication adherence, and follow-up with primary care providers. This position may directly interact with patients to complete tasks for quality gap closure. 

The Regional Quality Coordinator will support the assigned market under the direction of the market VP with the assistance of the National Quality Manager.

Essential Functions
  • Understands the principles of CMS, HEDIS, NCQA, Health Plan Quality Standards, CAHPS, HOS, and HIPAA
  • Provides support to the Quality Management Department by working with members and network providers to improve quality of care through quality activities such as HEDIS, CMS Star Rating, and other quality performance reporting
  • Provides telephonic outreach to patients, providers, and pharmacies to discuss opportunities for optimizing medication use or other opportunities for improvement of healthcare performance measure related issues 
  • Improves patient experience and transitions for better healthcare outcomes through quality care
  • Participates in data collecting through medical record and claims surveillance 
  • Works to maximize health plan and healthcare provider performance on healthcare related quality measures through effective telehealth communication with patients and coordination with patient caregivers, providers, and pharmacies.
  • Assists in planning, implementing, and executing projects to improve quality and delivery of care services 
  • Using research and knowledge, identifies potential interventions to improve quality strategies
  • Participates in Quality Management meetings and other initiatives
  • Prepares quality information for presentation to affiliate groups, including groups current standings relative to others and opportunities or improvement
  • Point of Contact for provider groups designated by leader
  • Leads project management of Quality Fairs, Diabetic Days, and P3 events to maximize quality gap closure 
  • Subject Matter Expert in P3 machines (diabetic eye camera, bone density machine, etc.)
  • Responds to health plan, provider and interdepartmental calls in accordance with exceptional customer service 
  • Reviews provider group gap uploads through the P3 Provider portal
  • Other duties as assigned 
Education and Experience
  • High school diploma/GED required, associate degree in related field or equivalent experience preferred.
  • 2+ years experience in healthcare-related fields required, clinical health care related experience, managed care, or Health plan experience strongly preferred.
  • Experience with Microsoft Word, Excel, Power Point, Outlook and general office equipment such as copier, fax machine, required.
  • Experience in Electronic Health Records required.
  • Medical Assistant Certification or experience as a Pharmacy Tech, Radiology Tech, Lab Tech or similar strongly preferred. 
  • Experience with data mining is preferred.
  • Medical terminology knowledge required, experience with CPT II codes preferred.
Work Conditions
  • Availability to travel within assigned region and work from multiple providers offices as needed.
  • Must have a valid driver’s license, safe driving record, and able to furnish reliable transportation.  
 Work Location & Schedule

This role offers a hybrid work arrangement. Candidates will follow our hybrid schedule, working in office three days per week. 

Pay range per hour: $22 - $28 based on experience

About P3People. Passion. Purpose.  

At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.

We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.  

We are looking for a Regional Quality Coordinator.  If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization, then you should consider joining our team.



What P3 Health Partners employees say

Pay

Workplace

Get the full story on Breakroom