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Provider Manager Jobs in Oregon (NOW HIRING)

Modivcare, Inc.

OR

$52K - $70K/yr

Manages provider relationships at a local and regional level. * Identifies opportunities for improvement through ongoing provider communication. * Conducts training sessions for providers and other ...

Umpqua Health Newton Creek

Provider

Roseburg, OR

$125K - $150K/yr

Prescribe and manage medications, therapies, and other specialized medical care. Collaborate closely with primary care providers and specialists to ensure continuity of care and optimal patient ...

Advantage Home Care

Care provider

Roseburg, OR · On-site

$18.25 - $20.85/hr

... managed. We pride ourselves on getting to know and care for our caregivers and our clients. Advantage Home Care offers paid and personalized training and regular check-ins to help our staff provide ...

W3Global Inc.

Longevity Medical Provider

Lake Oswego, OR · On-site

$160K - $200K/yr

Ideal for providers passionate about wellness, longevity medicine, and aesthetic treatments. Job ... Lead and manage longevity programs, including peptide therapy and HRT * Review labs and ensure safe ...

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Provider Manager information

How do I become a provider manager?

To become a provider manager, candidates typically need a bachelor's degree in healthcare administration, business, or a related field, along with relevant experience in healthcare or provider relations. Strong communication, organizational skills, and knowledge of healthcare policies are essential, and some roles may require certification such as Certified Provider Relations Professional (CPRP). Gaining experience in healthcare operations or provider networks can also improve prospects for advancement into this role.

What are some common challenges provider managers face when coordinating between healthcare providers and insurance companies?

Provider Managers often navigate complex relationships between healthcare providers and insurance companies, which can involve resolving contract disputes, ensuring compliance with regulatory standards, and streamlining credentialing processes. They frequently manage competing priorities, such as maintaining strong provider networks while meeting organizational cost and quality goals. Effective communication, negotiation skills, and up-to-date knowledge of industry regulations are crucial for overcoming these challenges and maintaining productive partnerships.

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

To thrive as a Provider Manager, you need expertise in healthcare administration, provider relations, and a solid understanding of regulatory compliance, typically supported by a bachelor’s degree in healthcare management or a related field. Familiarity with provider network management systems, credentialing software, and data analytics tools is highly valued. Strong interpersonal skills, negotiation abilities, and effective communication are essential for building relationships with providers and leading teams. These skills and qualities are crucial for ensuring high-quality provider networks, regulatory adherence, and efficient healthcare delivery.

What is a provider manager?

A Provider Manager is a professional responsible for overseeing relationships with healthcare providers, such as physicians, clinics, or hospitals, within an organization like a health insurance company or healthcare network. Their duties often include recruiting new providers, negotiating contracts, ensuring quality standards are met, and serving as a liaison between providers and the organization. Provider Managers play a key role in maintaining a strong provider network, resolving issues, and supporting operational efficiency to ensure members receive high-quality care.
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 Manager jobs? Cities in Oregon with the most Provider Manager job openings:
Provider Manager jobs near you

Provider Network Specialist

Cascade Comprehensive Care Inc

Klamath Falls, OR • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 28 days ago

Job description

SUMMARY

The Provider Network Specialist provides operational support for provider network management and credentialing functions. This position serves as a resource for provider onboarding, credentialing coordination, provider data maintenance, provider communications, reporting support, and provider network administration activities. The Provider Network Specialist works collaboratively with internal departments, providers, medical groups and administrative staff to ensure accurate provider information, timely credentialing and recredentialing activities, compliance with organizational requirements, and a positive provider experience by performing the following duties.

  • Supports provider onboarding, credentialing, and recredentialing activities to ensure providers meet participation requirements and maintain compliance.
  • Maintains accurate provider demographic and directory information to support regulatory compliance and member access to care.
  • Assists with provider relations activities, including provider outreach, education, communications, issue resolution, and onboarding support.
  • Supports provider network monitoring activities, including access and availability reviews, ADA accommodation tracking, secret shopper reviews, and provider data validation.
  • Coordinates administrative activities for provider network management and credentialing, including report preparation, Provider Network Management Committee support, document management, and project tracking.
  • Serves as administrative support contact for provider and clinic inquiries related to network participation, directory information and provider relations.
  • Assists with provider onboarding activities, including collection and tracking of required documentation.
  • Conducts routine provider outreach to verify provider information, office hours, capacity, ADA accommodations, and other network data.
  • Assists with provider recruitment activities by coordinating outreach efforts, tracking opportunities, and maintaining recruitment records.
  • Supports provider education initiatives through preparation and distribution of provider communications, training materials and updates.
  • Maintains provider contract warehouse and other related documentation.
  • Assists with preparation of provider network adequacy, access, and availability metrics to assist with monitoring procedures.
  • Provides administrative support for the credentialing and recredentialing process.
  • Conducts outreach to providers, clinics, and office staff regarding missing or incomplete credentialing documentation when necessary.
  • Performs data entry and updates provider information within credentialing and provider management systems.
  • Responds to routine credentialing inquiries.
  • Maintains confidentiality and complies with HIPAA rules and regulations.
  • Maintains punctual, regular, and predictable attendance.
  • Works collaboratively in a team environment with a spirit of cooperation.
  • Displays excellent communication skills including presentation, persuasion, and negotiation skills required in working with members and coworkers, including the ability to communicate effectively and remain calm and courteous under pressure.
  • Respectfully takes direction from manager.

EDUCATION and/or EXPERIENCE

Associate's degree or equivalent from two-year college or university; and two to three years related experience and/or training; or equivalent combination of education and experience.

COMPUTER SKILLS

Job requires specialized computer skills. Must be adept at using various applications including database, spreadsheet, report writing, project management, graphics, word processing, presentation creation/editing, communicate by e-mail and use scheduling software.

We provide a competitive salary and excellent benefits, including vacation, medical, dental and vision insurance, and 401(k) pension plan. To apply for this position, please submit a cover letter and resume. We are an Equal Opportunity Employer.



Background Check & Drug Screen Required