Prior Authorization Review Coordinators – two
2 weeks ago
Do you have an interest in helping Oregonians in need by assisting healthcare providers? Do you have at least three years of experience dealing with the public in-person or by phone providing information about services and programs; explaining rules, programs, and procedures; and/or providing assistance, explaining requirements, and gaining compliance? We look forward to hearing from you
to view a Dashboard of all current recruitments for the Behavioral Health Division, Medicaid Division, and the Office of Data Strategy & Operations (which were previously all part of ). The specific positions associated with this posting are listed under REQ-157052. The dashboard identifies the business area (“Section”) and Unit for each position and also provides a link to a position description to offer you greater context for the role. Section 1 of the position description outlines Position Information, including Work Location and Supervisor Name. Section 3 outlines the Description of Duties.
This posting will be used to fill two (2) permanent, full-time position. These positions are classified and are represented by a union.
Work Location: Salem/Marion; hybrid position
What you will do
The Prior Authorization Review Coordinator (PARC) is responsible for receiving prior authorization (PA) requests for services covered by the Oregon Health Plan and initiating the steps required to complete the processing, review and determination of the PA requests. This position utilizes Oregon Administrative Rules, member information and benefit package information to interpret applicable rules, regulation, decisions, policies and procedures to ensure that complete and accurate PA information has been received from the requestor and assisting the requester with compliance of program requirements.
This position also supports Medicaid service providers by operating a provider hotline during normal business hours, and by managing a variety of tasks related to prior authorization and unit functions.
OHA values service excellence, leadership, integrity, health equity and partnership and has a strategic goal to end all health inequities by 2030.
The OHA mission is helping people and communities achieve optimum physical, mental, and social well-being through partnership, prevention and access to quality, affordable health care. OHA’s work is organized into three broad goals: Improve the lifelong health of all Oregonians, increase the quality, reliability, and availability of care for all Oregonians and lower or contain the cost of care so it is affordable to everyone.
What's in it for you?
Oregon Health Authority is a team of passionate individuals working to promote health across the lifespan of individuals, families, and communities. We value and support unique perspectives using a trauma-informed approach and aim to reflect these values in our hiring practices, professional development, and workplace.
- We offer exceptional benefits packages for you and your qualified family members, with very low monthly out-of-pocket costs. Try this free virtual benefits counselor by clicking here:
- Paid Leave Days:
- 11 paid holidays each year
- 3 additional paid "Personal Business Days" each year
- 8 hours of paid sick leave accumulated every month
- Progressive vacation leave accrual with increases every 5 years
- Optional benefits include short-term disability, long-term disability, deferred compensation savings program, and flexible spending accounts for health care and childcare expenses.
- Click to learn more about State of Oregon benefits.
OHA values health equity, service excellence, integrity, leadership, partnership, innovation and transparency. OHA’s health equity definition is “Oregon will have established a health system that creates health equity when all people can reach their full potential and well-being and are not disadvantaged by their race, ethnicity, language, disability, age, gender, gender identity, sexual orientation, social class, intersections among these communities or identities, or other socially determined circumstances. Achieving health equity requires the ongoing collaboration of all regions and sectors of the state, including tribal governments to address: the equitable distribution or redistributing of resources and power; and recognizing, reconciling, and rectifying historical and contemporary injustices.” OHA’s 10-year goal is to eliminate health inequities. Click , to learn more about OHA’s mission, vision and core values.
WHAT WE ARE LOOKING FOR:
Minimum Qualifications
Three years of experience performing public contact and/or customer service duties comparable to the work of a Public Service Representative.
At least two years of this experience must include dealing with the public in-person or by phone providing information about services and programs; explaining rules, programs, and procedures; and/or providing assistance, explaining requirements, and gaining compliance.
Desired Attributes
- Experience supporting the implementation of policies, projects and programs at the community, state, and/or national level that advance health equity, address systemic health disparities, and elevate the voice of community and those with lived experience.
- Experience within the context of healthcare claims processing.
- Knowledge of federal requirements, state rules and program requirements for the Oregon Medicaid Program
- Demonstrates skills in the following areas:
- Constructive and Collaborative Working Relationships
- Critical Decision-making and Problem-solving
- Customer Service and Person-centered Engagement
- Data Synthesis, Analysis and Reporting
- Project Planning and Prioritization
- Workload Planning & Prioritization
- Strong Oral and Written Communication, including preparation of reports
- Technical and Computer Skills
- Training and Technical Assistance
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