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Payer Strategy Manager Jobs in Oregon (NOW HIRING)

Adventist Health

Chart Auditor (Portland)

Portland, OR · On-site

$52.55 - $78.77/hr

... and payer requirements for authorization and coverage. Collaborates with Case Management ... strategies. Performs charge audits and account reconciliations to ensure documentation is ...

Dendreon Corporation

Experience managing relationships with payers, specialty distributors, specialty pharmacies, and provider networks. Core Competencies * Strategic thinking and execution in market access ...

BetterHelp

OR · On-site

$120K - $150K/yr

Identify trends in payer behavior and surface them for leadership review * Coordinate with various ... Comfortable with ambiguity and seeks opportunities to shape operational strategy and initiatives

Ardelyx

$223K - $273K/yr

The Director, Field Access Management is responsible for providing strategic leadership and ... The Director will serve as a key subject matter expert on the payer landscape, collaborating cross ...

HealthEdge

Ensure products are clinically relevant, user-centric, and integrated into existing payer and ... strategic goals and industry best practices * Leads and manages teams, often geographically ...

Groups Recover Together, Inc.

... payer mix, clinical model, and strategic adjacencies. Pipeline & Origination. Build and manage a proprietary pipeline of SUD, behavioral health, and adjacent targets; cultivate long-lead ...

Inizio

Hybrid Access Manager

Portland, OR · On-site

$91K - $169K/yr

The ARM maintains a strong understanding of the payer landscape and may conduct in-person HCP ... About Inizio Engage Inizio Engage is a strategic, commercial, and creative engagement partner that ...

HealthEdge

HealthRules Payer Configuration Analyst

$100K - $120K/yr

Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members' well ... strategies, as needed * Work independently to solve and test complex scenarios * Analyze data and ...

Cotiviti

$115K - $155K/yr

In this strategic role, you will act as a trusted advisor to our healthcare payer clients ... Act as the lead relationship manager for assigned accounts, coordinating proactive customer ...

Stryker Corporation

Medical Billing Director

Medford, OR · On-site

$100 - $125/hr

... strategic and operational leadership for the organization's behavioral health billing operations ... This position is responsible for claims management, payer relations, reimbursement optimization ...

Bausch & Lomb

OR

Demonstrated experience in payer account management, including contracting strategies and strategic account planning to optimize patient access while achieving profitability targets. * Proven success ...

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Payer Strategy Manager information

What is the difference between Payer Strategy Manager vs Payer Account Manager?

AspectPayer Strategy ManagerPayer Account Manager
CredentialsBachelor's degree, healthcare or business background, sometimes an MBABachelor's degree, healthcare or business background, often with sales or account management experience
Work EnvironmentStrategic planning, market analysis, cross-functional collaborationClient relationship management, sales, contract negotiations
Employer & Industry UsageHealth insurance companies, pharmaceutical firms, healthcare consultingHealth insurance companies, managed care organizations, pharmaceutical companies

The Payer Strategy Manager focuses on developing and implementing payer strategies through market analysis and cross-functional collaboration. In contrast, the Payer Account Manager primarily manages client relationships, negotiates contracts, and maintains payer accounts. While both roles work within the healthcare payer industry, the Strategy Manager emphasizes planning and market positioning, whereas the Account Manager concentrates on client retention and sales.

What are the key skills and qualifications needed to thrive as a payer strategy manager?

To thrive as a Payer Strategy Manager, you need expertise in healthcare policy, data analysis, contract negotiation, and a background in business, healthcare administration, or a related field. Familiarity with claims management systems, financial modeling tools, and payer-provider platforms is typically required, along with relevant certifications such as Certified Professional in Healthcare Management (CPHM). Strong analytical thinking, relationship-building, and strategic communication skills help set top performers apart in this role. These capabilities are crucial for developing effective payer strategies, optimizing reimbursement, and maintaining productive partnerships with insurance payers.

What is a payer strategy manager?

A Payer Strategy Manager is a professional in the healthcare industry responsible for developing and implementing strategies related to health insurance payers, such as insurance companies, government programs, and managed care organizations. Their role involves analyzing market trends, negotiating contracts, and ensuring that products and services align with payer requirements to optimize reimbursement. They often collaborate with sales, marketing, and product teams to support business growth and maintain strong payer relationships. Payer Strategy Managers play a key role in shaping how healthcare organizations interact with payers to maximize access and profitability.

What are the primary challenges a payer strategy manager faces when aligning internal teams with payer requirements?

A Payer Strategy Manager often navigates the complex task of bridging internal cross-functional teams, such as sales, medical, and market access, with the evolving requirements of payers. This requires not only an in-depth understanding of payer policies and reimbursement landscapes but also strong communication skills to translate these requirements into actionable strategies. One common challenge is ensuring that all stakeholders remain informed and agile as payer expectations shift, which means the role demands adaptability and proactive coordination. Success often relies on building collaborative relationships and maintaining open channels of communication across departments.
What are the most commonly searched types of Payer Strategy jobs in Oregon? The most popular types of Payer Strategy jobs in Oregon are:
What are popular job titles related to Payer Strategy Manager jobs in Oregon? For Payer Strategy Manager jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Payer Strategy Manager jobs in Oregon look for? The top searched job categories for Payer Strategy Manager jobs in Oregon are:
What cities in Oregon are hiring for Payer Strategy Manager jobs? Cities in Oregon with the most Payer Strategy Manager job openings:
Payer Strategy Manager jobs near you
Infographic showing various Payer Strategy Manager job openings in Oregon as of June 2026, with employment types broken down into 93% Full Time, and 7% Part Time. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution.

Chart Auditor (Portland)

Adventist Health

Portland, OR • On-site

Other

Re-posted 18 days ago

Adventist Health rating

7.7

Company rating: 7.7 out of 10

Based on 243 frontline employees who took The Breakroom Quiz

158th of 887 rated healthcare providers

Job description


Adventist Health Portland is looking for Chart Auditor for Full-time, Day Shift. We are looking for great individual who can work onsite to our location in Portland, OR
Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.
Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Summary:
Supports the Revenue Management Department by auditing medical records and clinical documentation to ensure proper patient status placement, accurate coding, and defensible payer billing. Focuses on clinical denials, observation services, documentation gaps, and payer requirements for authorization and coverage. Collaborates with Case Management, Utilization Management, Coding, Medical Officer, and Physician Advisors to reduce clinical denials, improve documentation quality, and ensure compliance with regulatory and payer standards. Provides analytic reports and feedback to identify systemic trends and educational opportunities.
Job Requirements:
Education and Work Experience:
  • Associate's degree in Nursing or related clinical field: Required
  • Bachelor's Degree in Nursing (BSN) or Healthcare Administration: Preferred
  • Prior experience in utilization review, case management, coding, or clinical auditing: Preferred
Licenses/Certifications:
  • Current licensed RN in the state of practice (RN), medical provider (MD), or International Medical Graduate with valid credential: Required
  • Registered Nurse (RN) or Medical license MD (MD) or Foreign Medical Doctor (FMD): Required
Essential Functions:
  • Conducts concurrent audits of active cases to identify documentation and order issues in real time, preventing downstream denials. Applies InterQual or Milliman/MCG criteria to validate patient status decisions and payer medical necessity compliance.
  • Reviews medical records to validate patient placement (inpatient vs. observation) against payer criteria and physician orders. Audits clinical denials to determine root cause, trends, and opportunities for appeal, and recommends actionable prevention strategies. Performs charge audits and account reconciliations to ensure documentation is appropriate, compliant with regulations, and free of denial risk. Provides recommendations for charge corrections and technical assistance in staff training.
  • Identifies barriers to clean claims and timely payment; tracks and trends denials, escalating systemic issues to the Director/Manager. Tracks and trends payer clinical denials, observation hours, and placement errors; prepares reports for Revenue Management leadership. Provides feedback to Coding and CDI teams regarding documentation needed for coding accuracy and DRG assignment.
  • Partners with Case Management, Utilization Management, Medical Officer, and Physician Advisors to ensure accurate clinical documentation and timely status changes. Collaborates in payer escalations and appeal preparation by supplying clinical and documentation findings. Educates providers and staff on documentation, status order accuracy, and denial prevention strategies.
  • Monitors CMS, state, and commercial payer regulatory changes impacting clinical documentation, placement, and observation requirements; integrates updates into audit practices. Demonstrates reliability, responsiveness, and effective follow-up on matters requiring attention.
  • Performs other job-related duties as assigned.

Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit https://adventisthealth.org/careers/everify/ for more information about E-Verify. By choosing to apply, you acknowledge that you have accessed and read the E-Verify Participation and Right to Work notices and understand the contents therein.
About Us
Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.

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