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Provider Contract Jobs in Oregon (NOW HIRING)

Careoregon

Provider Relations Specialist II

OR · On-site +1

Provider Relations Specialist II ----- Job Summary This position serves as a primary liaison ... This position will assist with the contract development process, site visits, and general ...

Magicforce

Facets NetworX Pricing Analyst

Portland, OR · On-site

$60 - $70/hr

Provider Pricing Configuration * Contract Pricing Setup * Claims Pricing Validation * Experience performing claims analysis and pricing validation. * Working knowledge of: * SQL * Reporting Tools

Cascadia Health

Contract Administrator

Portland, OR · On-site

$82K - $88K/yr

Provide guidance to internal teams on contract interpretation and terms and support training on contract topics. * Maintain and continuously improve contract administration policies, procedures ...

Legacy Health

Contract Administrator

Portland, OR · On-site

$41.04 - $61.16/hr

Responsibilities Contract Administrator : Accountable for all tactical strategic sourcing and ... As directed, provides assistance in procurement for high-value and/or high-risk projects and other ...

Legacy Health

Contract Administrator

Portland, OR

$41.04 - $61.16/hr

Contract Administrator : Accountable for all tactical strategic sourcing and contracting activities ... As directed, provides assistance in procurement for high-value and/or high-risk projects and other ...

Higher Logic

Contract Specialist

OR · On-site +1

Ability to analyze contract terms and conditions to identify potential risks and provide recommendations. Team Collaboration: Ability to work independently and collaboratively within a team ...

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Provider Contract information

What is a provider contract?

A provider contract is a formal agreement between a healthcare provider, such as a doctor or hospital, and a health insurance company or managed care organization. This contract outlines the terms under which the provider will deliver medical services to insured members, including reimbursement rates, covered services, and billing procedures. Provider contracts help ensure that patients receive agreed-upon care at predetermined costs and establish the responsibilities of both the provider and the insurer. These agreements are essential for maintaining a network of healthcare professionals who serve plan members.

What are the key skills and qualifications needed to thrive as a provider contract specialist, and why are they important?

To excel as a Provider Contract Specialist, you need strong analytical abilities, knowledge of healthcare regulations, contract negotiation skills, and typically a bachelor's degree in business, healthcare administration, or a related field. Familiarity with contract management software, healthcare reimbursement systems, and proficiency in Microsoft Office are commonly required. Excellent attention to detail, communication, and relationship-building skills help you collaborate effectively with providers and internal stakeholders. These competencies ensure accurate contract execution, regulatory compliance, and mutually beneficial agreements in a complex healthcare environment.

What are some common challenges faced by professionals in provider contract roles, and how can they be addressed?

Professionals in provider contract roles often encounter challenges such as navigating complex regulatory requirements, ensuring contract compliance, and balancing the interests of both healthcare providers and payers. Additionally, they may need to negotiate terms that are both competitive and sustainable for their organization. These challenges can be addressed by staying up-to-date with industry regulations, developing strong negotiation and communication skills, and fostering collaborative relationships with internal legal, compliance, and finance teams.

What is the difference between Provider Contract vs Medical Billing Specialist?

AspectProvider ContractMedical Billing Specialist
CredentialsTypically requires healthcare administration, legal, or business certificationsRequires coding, billing, and healthcare reimbursement certifications
Work EnvironmentHealthcare facilities, insurance companies, or legal officesMedical offices, billing companies, or healthcare providers
Industry UsageUsed in healthcare contracting, negotiations, and legal agreementsUsed in processing insurance claims and patient billing

While Provider Contract specialists focus on creating and managing agreements between healthcare providers and payers, Medical Billing Specialists handle the coding and submission of claims for reimbursement. Both roles are essential in healthcare finance but serve different functions within the revenue cycle.

What are the most commonly searched types of Provider jobs in Oregon?

The most popular types of Provider jobs in Oregon are:

What cities in Oregon are hiring for Provider Contract jobs?

Cities in Oregon with the most Provider Contract job openings:

Provider Contract jobs near you

SHP Provider Contract Coordinator

Corvallis, OR • On-site

Samaritan Health Services

6.8

Company rating: 6.8 out of 10

Based on 67 frontline employees who took The Breakroom Quiz

499th of 893 rated healthcare providers

People enjoy working here

Recommended by parents

Respectful managers

Learn more about Samaritan Health Servicesexternal

$21.98 - $32.27/hr

Full-time

Re-posted 20 days ago

Job description

This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin.
  • JOB SUMMARY/PURPOSE
    • Responsible for supporting the administration, tracking, and maintenance of provider contracts and related documentation. Coordinates contract workflow activities, ensures accurate system configuration, and assists with oversight and communication with delegated entities related to credentialing requirements. Serves as a key liaison between Contracting, Credentialing, Compliance, and delegated provider groups to ensure contractual and regulatory obligations are met.
  • DEPARTMENT DESCRIPTION
    • Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage and Commercial Large Group plans. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services' mission of Building Healthier Communities Together.
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • High school diploma or equivalent required.
    • Three (3) years of experience in healthcare contracting, provider network operations, credentialing, or related managed care functions required.
    • Experience supporting provider contract administration and/or credentialing processes required.
    • Experience working with contract management systems, provider databases, or workflow tracking tools required.
    • Experience working with delegated credentialing models within Medicaid, Medicare Advantage, or Commercial health plans preferred.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Knowledge of provider contracting lifecycle and documentation requirements. Understanding of credentialing standards (e.g., CMS, state Medicaid, NCQA, or URAC requirements).
    • Strong organizational skills and attention to detail. Analytical skills to review documentation for completeness and compliance.
    • Ability to manage multiple projects and deadlines simultaneously.
    • Effective written and verbal communication skills.
    • Ability to collaborate cross-functionally with Contracting, Credentialing, Compliance, and delegated provider entities.
    • Proficiency in Microsoft Office and contract tracking systems.
  • PHYSICAL DEMANDS
    • Rarely
      (1 - 10% of the time)
      Occasionally
      (11 - 33% of the time)
      Frequently
      (34 - 66% of the time)
      Continually
      (67 - 100% of the time)
      CLIMB - STAIRS
      LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
      LIFT (Knee to chest: 24"-54") 0 - 20 Lbs
      LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
      CARRY 1-handed, 0 - 20 pounds
      BEND FORWARD at waist
      KNEEL (on knees)
      STAND
      WALK - LEVEL SURFACE
      ROTATE TRUNK Standing
      REACH - Upward
      PUSH (0 - 20 pounds force)
      PULL (0 - 20 pounds force)
      SIT
      CARRY 2-handed, 0 - 20 pounds
      ROTATE TRUNK Sitting
      REACH - Forward
      MANUAL DEXTERITY Hands/wrists
      FINGER DEXTERITY
      PINCH Fingers
      GRASP Hand/Fist

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