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Provider Contract Jobs in Oregon (NOW HIRING)

OR · Hybrid

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 ...

Provide contract administration support throughout the contract lifecycle, including contract award, modification processing, contract maintenance, and contract closeout activities. * Review and ...

Provide administrative support to the legal team, including scheduling meetings, preparing reports ... Contract Law Knowledge : Strong understanding of contract law, legal terminology, and principles.

CONTRACT SPECIALIST

Portland, OR · On-site +1

$54K - $125K/yr

Provides business advice and assistance to technical personnel involved in the development of the ... Prepares solicitation, amendment, and contract documents incorporating applicable terms, conditions ...

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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 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 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 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 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 Manager I (Hybrid)

Northwest Permanente

Portland, OR • Hybrid

$94K - $126K/yr

Part-time

Medical, Retirement, PTO

Posted 10 days ago


Job description

Overview

The Provider Contract Manager I supports the provider contracting function by negotiating Single Case Agreements, managing a portfolio of contracts, and supports more senior Provider Contract Managers or department leadership in the negotiation of complex contracts. The management of the contracts involves reporting and communications to apprise key stakeholders on the status of various contract initiatives.Major Responsibilities: 

  • Develops Single Case Agreements.
  • Communicates details surrounding Single Case Agreements to appropriate stakeholders and into downstream systems to ensure accurate and timely administration.
  • Develops and maintains relationships and workflows with internal and external stakeholders that result in Single Case Agreements that meet care delivery needs within financial guardrails, budgets, and timelines.
  • Tracks Single Case Agreements developed over time.  Monitors and reports trends such as the identification of high utilization providers who should be transitioned to full contracts.
  • Applies process improvement principles to continuously improve Single Case Agreement processes, document standard work, and inform stakeholders of any proposed modifications necessary to streamline processes.
  • Manages a portfolio of contracts that are predictable and have a low level of complexity.
  • In partnership with contracting team members, develops and delivers progress and status reports, executive summaries, dashboards for large contracting initiative project deliverables, and overall status reports of key contracting initiatives intended to inform stakeholders and senior leaders on progress toward achieving contracting initiative deliverables and timelines.
  • Identifies and resolves critical business barriers to agreed-upon contractual obligations and negotiated deliverables while providing succinct reporting to leadership. 

Minimum Qualifications: 

  • Bachelor's degree in business, finance, healthcare administration or related field, or equivalent education and experience.
  • Minimum three (3) years of experience in managed care provider contracting, provider relations, or comparable role, including project or portfolio management.
  • Minimum one (1) year experience in project coordination or project management.
  • Demonstrated ability to synthesize complex content to concise, impactful dashboards and reporting. Ability to influence various high-level stakeholders through clear, concise and powerful communication.
  • Excellent interpersonal and customer service skills. Ability to develop and maintain positive working relationships with both internal and external stakeholders. Ability to work cooperatively, sensitively, and tactfully while maintaining professionalism.
  • Possess strong financial acumen including basic knowledge of hospital, physician, skilled nursing and ancillary provider reimbursement models for commercial and government payers.

About Northwest Permanente:We are the Permanente in Kaiser Permanente. Northwest Permanente is a self-governed, multi-specialty group of 1,500 physicians, clinicians, and administrative professionals caring for 630,000 members in Oregon and Southwest Washington. Together with Kaiser Foundation Health Plans and Kaiser Foundation Hospitals, we form Kaiser Permanente of the Northwest, an integrated health care program.  Kaiser Permanente is one of the nation's preeminent health care systems, a benchmark for comprehensive, integrated, value-based, and high-quality care.Our Northwest Permanente administrative professionals enjoy a wide range of company sponsored benefits:

  • 15% employer contribution to retirement programs, including pension
  • 90% employer-paid health plan
  • Tuition Reimbursement
  • Child Care Benefits
  • Flexible Work Schedules
  • Paid Parental Leave
  • Self-Care Days + Paid Time Off

Equal Opportunity EmployerNorthwest Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.

Employment Type: PART_TIME