Provider Relations Specialist II

4 days ago


Portland, Oregon, United States CareOregon Full time
About the Role

CareOregon is seeking a highly skilled Provider Relations Specialist II to join our team. As a key member of our Provider Relations department, you will play a critical role in building and maintaining strong relationships with our provider network.

Key Responsibilities
  • Provider Development and Education: Develop and maintain effective working relationships across the provider network, ensuring a high-quality provider network.
  • Provider Relations: Cultivate relationships with providers to enhance the provider experience, access to quality of care for members, and healthcare transformation.
  • Internal Liaison: Participate on interdepartmental initiatives and teams, providing knowledgeable insights and contributions.
  • Contract Initiation: Identify potential providers that may enhance the network, obtain and review provider application data, and support the Contracting team in facilitation of provider contract terminations.
  • Administration: Provide input and contribute to the development of relevant policies and procedures, actively participate in department meetings, and consult and inform on CareOregon program development and initiatives.
Requirements
  • Minimum 4 years' relevant experience relating to physical and/or behavioral health, including involvement in several of the following areas: Provider relations, managed care operations, medical/behavioral health clinic operations, and/or related healthcare functions.
  • Valid drivers license, acceptable driving record, and automobile liability coverage or access to an insured vehicle.
Preferred Qualifications
  • Strong understanding of managed care and the Oregon Health Plan.
  • Knowledge of fee schedules and healthcare payment methodologies.
  • Strong understanding of provider network (physical and/or behavioral health).
  • Strong understanding of medical clinic operations.
About CareOregon

CareOregon is a community-based health plan that serves over 400,000 Oregon Health Plan members. We are committed to building a linguistically and culturally diverse and inclusive work environment.



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