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Provider Manager Jobs in Oregon (NOW HIRING)

CareOregon

Director, Provider Data Management

Portland, OR · On-site

$155.43 - $189.97/hr

Director, Provider Data Management-This position is responsible for enterprise leadership and strategic oversight of CareOregon's provider network data management, including provider data management ...

Nhcoregon

Per Diem Provider (MD, DO)

Portland, OR · On-site

$200 - $250/hr

Provides oversight of support staff with respect to individual patient management. * Participates in team huddles to review the schedule at the start of the clinic day. * Participates in process and ...

Legacy Health

Provider Recruiter

Portland, OR · On-site

$48.91/hr

As a member of a small collaborative team of provider recruiters, supported by a dedicated Talent Acquisition Operations team, you will manage the full recruitment lifecycle from sourcing and ...

Legacy Health

Provider Recruiter

Portland, OR · On-site

$48.91 - $72.88/hr

As a member of a small collaborative team of provider recruiters, supported by a dedicated Talent Acquisition Operations team, you will manage the full recruitment lifecycle from sourcing and ...

Legacy Health

Provider Recruiter

Portland, OR · On-site

$48.91 - $72.88/hr

As a member of a small collaborative team of provider recruiters, supported by a dedicated Talent Acquisition Operations team, you will manage the full recruitment lifecycle from sourcing and ...

Outside In

Advanced Practice Provider

Portland, OR · On-site

$131K - $145K/yr

The APP diagnoses, treats and manages acute and chronic health conditions, and provides preventive care focused on health risk factor reduction and patient self-management. The APP works in a care ...

OUTSIDE IN

Advanced Practice Provider

Portland, OR · On-site

$92K - $127K/yr

The APP diagnoses, treats and manages acute and chronic health conditions, and provides preventive care focused on health risk factor reduction and patient self-management. The APP works in a care ...

OUTSIDE IN

Advanced Practice Provider

Portland, OR · On-site

$131K - $145K/yr

The APP diagnoses, treats and manages acute and chronic health conditions, and provides preventive care focused on health risk factor reduction and patient self-management. The APP works in a care ...

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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

Director of Provider Contracting

Samaritan Health Services

Corvallis, OR • Remote

Full-time

Posted 11 days ago

Samaritan Health Services rating

7.5

Company rating: 7.5 out of 10

Based on 65 frontline employees who took The Breakroom Quiz

232nd of 887 rated healthcare providers

Job description

  • Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.

    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.

    This is a remote position in which we are able to employ in the following states: Alabama, Alaska, 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, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

  • JOB SUMMARY/PURPOSE
  • The Director of Provider Contracting is responsible for the strategic leadership, financial oversight, and operational management of the health plan’s Provider Contracting Department within the Finance division of Samaritan Health Plans. This role oversees provider contract development, negotiation, reimbursement methodology design, and contract lifecycle management across all applicable lines of business. The Director will ensure alignment with financial objectives, actuarial assumptions, regulatory requirements, and organizational strategy.
  •  
  • Our ideal candidate will have the following experience: 
    • Experience with contract financial forecasts or spend
    • Excellent communication skills
    • Knowledge of credentialing
    • Network adequacy and network management
    • Management of staff, budgets, contract negotiations, medicare and/or medicaid contract terms
  •  
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Bachelor's degree or equivalent experience in a related field required. Master's degree preferred.
    • Seven (7) years of experience in provider contracting, reimbursement strategy, or healthcare finance, including two (2) years leadership experience, required.
    • Experience in reimbursement methodologies, financial modeling, and healthcare regulatory requirements (Medicaid, Medicare Advantage, D-SNP, Commercial) required.
    • Experience negotiating with hospitals, physician groups, ancillary providers, and health systems required.
    • Experience collaborating with Finance, Actuarial, Legal, and Compliance departments required.
  •  
  • KNOWLEDGE/SKILLS/ABILITIES
    • Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
    • Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
    • Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
    • Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.
  •  
  • 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)

      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
       

      CARRY 2-handed, 0 - 20 pounds
       

      KNEEL (on knees)
       

      BEND FORWARD at waist
       

      CLIMB - STAIRS

      STAND
       

      WALK - LEVEL SURFACE
       

      ROTATE TRUNK Standing
       

      REACH - Upward
       

      PUSH (0-20 pounds force)
       

      PULL (0-20 pounds force)

      SIT
       

      ROTATE TRUNK Sitting
       

      REACH - Forward
       

      MANUAL DEXTERITY Hands/wrists
       

      FINGER DEXTERITY
       

      PINCH Fingers
       

      GRASP Hand/Fist

      None specified

What Samaritan Health Services employees say

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