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Provider Network Management Jobs in Oregon (NOW HIRING)

Five9

OR

You will lead projects, own end-to-end troubleshooting, drive automation strategy, and provide ... Manage and operate data-center fabric services across hybrid and multi-cloud environments - on ...

BetterHelp

Senior Manager of Provider Experience

OR · On-site +1

Our network of over 30,000 licensed therapists has helped millions of people take ownership of ... Provide strong people management, coaching, and support to drive team effectiveness and growth

Humana

Provider Contracting Executive

OR · On-site +1

The Provider Contracting Executive communicates contract terms, payment structures, and ... of progressive network management experience including hospital contracting and network ...

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Provider Network Management information

What is provider network management?

A Provider Network Management job involves building, maintaining, and optimizing a healthcare provider network. Professionals in this role negotiate contracts, ensure provider compliance with regulations, and manage relationships with healthcare providers to maintain quality care and cost efficiency. They also analyze network performance, address gaps in coverage, and facilitate collaboration between insurers and providers. The goal is to ensure patients have access to high-quality care while keeping costs sustainable for healthcare organizations.

What does a provider network management do?

A provider network management professional oversees the relationships between healthcare providers and insurance companies, ensuring that providers meet contractual and quality standards. They coordinate provider enrollment, monitor network performance, and resolve issues to maintain a reliable network for members.

What are the key skills and qualifications needed to thrive in provider network management?

To excel in Provider Network Management, candidates typically need expertise in healthcare administration, contract negotiation, analytics, and a degree in a related field such as health services administration or business. Familiarity with network management platforms, claims processing systems, provider directories, and knowledge of regulations like HIPAA are highly valuable, as are certifications such as CPC or CPHQ. Strong relationship-building, problem-solving, and communication skills set top performers apart in facilitating partnerships between providers and healthcare payers. These abilities are essential to maintain robust provider networks, ensure compliance, and deliver quality healthcare services efficiently.

What are the typical daily responsibilities in provider network management?

In a Provider Network Management role, your day might include negotiating and administering contracts with healthcare providers, analyzing network performance metrics, and resolving provider issues or escalations. You’ll often collaborate with cross-functional teams such as claims, credentialing, and member services to ensure seamless network operations. Building and maintaining strong relationships with providers to address their needs, review compliance, and monitor service quality is a core part of the job. This position typically involves a mix of desk work, meetings, and occasional travel to visit provider offices or attend industry events.

What are popular job titles related to Provider Network Management jobs in Oregon? For Provider Network Management jobs in Oregon, the most frequently searched job titles are:
What job categories do people searching Provider Network Management jobs in Oregon look for? The top searched job categories for Provider Network Management jobs in Oregon are:
Provider Network Management jobs near you
Infographic showing various Provider Network Management job openings in Oregon as of August 2026, with employment types broken down into 100% Full Time. Highlights an 94% In-person, and 6% Remote job distribution.

Director of Provider Contracting

Samaritan Health Services

Corvallis, OR • Remote

Full-time

Posted 10 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

231st 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

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