Position Title: Senior Director Networking & ContractingDepartment: FinanceStatus: Full Time Exempt positionSchedule: Monday through Friday - 8:00am - 5:00pmLocation: Hybrid position - On-site & remote work requiredSalary: Wage Band 24: $147390 - $200000Only hiring from the state of Oregon preferably applicants residing in Douglas County| POSITION PURPOSE |
| The Senior Director of Network and Contracting provides strategic leadership for Umpqua Healths provider network strategy and oversees all contracting activities to ensure access to high-quality cost-effective care for members. This role is responsible for managing the Provider Relations Credentialing and Contracting/Network Development departments ensuring operational excellence and compliance with regulatory requirements. The Senior Director drives innovative reimbursement strategies including value-based care and bundled payments and fosters strong relationships with providers health systems and payors to support organizational growth and performance. |
| ESSENTIAL JOB RESPONSIBILITIES |
- Define and implement network strategy aligned with organizational goals and regulatory standards.
- Develop innovative contracting and reimbursement models including value-based arrangements and alternative payment structures.
- Provide executive-level guidance on network adequacy and compliance with Oregon Health Authority (OHA) requirements.
- Lead and manage the Provider Relations Credentialing and Contracting/Network Development teams ensuring collaboration and accountability.
- Establish departmental goals performance metrics and continuous improvement initiatives.
- Mentor and develop leadership within departments to build organizational capacity.
- Oversee negotiation drafting and execution of provider contracts including hospitals physician groups and ancillary services.
- Ensure contracts meet financial performance targets and regulatory standards.
- Monitor provider performance and implement strategies to address gaps and inefficiencies.
- Ensure adherence to state and federal regulations including Medicare and Medicaid requirements.
- Support audits reporting and credentialing compliance activities.
- Analyze contract performance and develop strategies to optimize cost and quality outcomes.
- Collaborate with finance and analytics teams to model reimbursement scenarios and forecast financial impact.
- Build and maintain strong relationships with providers health systems and payors to ensure network stability and growth.
- Represent Umpqua Health in external meetings and negotiations as needed.
|
| CHALLENGES |
- Working with a variety of personalities maintaining a consistent and fair communication style.
- Satisfying the needs of a fast paced and challenging company.
|
| QUALIFICATIONS KNOWLEDGE SKILLS AND ABILITIES |
Minimum Qualifications- Bachelors degree in Business Finance Healthcare Administration or related field required; Masters degree preferred. Fifteen year advanced experience will be considered in lieu of degree.
- Minimum 8 years of provider contracting experience in a managed care environment.
- Minimum 3 years of leadership experience managing multiple operational teams.
- Proven experience with value-based contracting and network development strategies.
Knowledge Skills and Abilities- In-depth understanding of managed care provider contracting credentialing and reimbursement methodologies.
- Expertise in Medicare Advantage Medicaid value-based contracting and alternative payment models.
- Advanced negotiation and strategic planning skills.
- Strong leadership and team development capabilities.
- Excellent communication and relationship-building skills.
- Ability to lead multiple departments and complex projects simultaneously.
- Ability to think creatively and strategically to solve problems and drive innovation.
|
| PHYSICAL DEMANDS & WORK CONDITIONS |
- Ability to sit for extended periods and use computer systems for documentation and communication.
- Frequent phone communication and virtual meetings.
- Field work includes home visits in varying environments; must be able to travel locally.
- Home Office Setup: Must have a designated workspace that supports ergonomic standards (desk chair with lumbar support monitor at eye level).
- Noise Level: Moderate typically from phone calls or virtual meetings.
- Technology Requirements: Reliable internet connection computer headset and other necessary peripherals.
- Ergonomic Considerations: Proper posture adjustable seating and monitor placement to prevent musculoskeletal strain. Employers often provide guidelines or stipends for ergonomic equipment
- Environmental Factors: Adequate lighting and ventilation; avoidance of prolonged work in non-ergonomic spaces (e.g. couches or beds).
- Work Hours: Regular predictable attendance in the Pacific time zone.
|
|
| EQUAL EMPLOYMENT OPPORTUNITY |
| UH is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race color sex religion sexual orientation national origin disability genetic information pregnancy or any other protected characteristic as outlined by federal state or local laws. This policy applies to all employment practices within our organization including hiring recruiting promotion termination layoff recall leave of absence compensation benefits training and apprenticeship. UH makes hiring decisions based solely on qualifications merit and business needs at the time. For more information read through our EEO Policy. |
About Umpqua Health
At Umpqua Health were more than just a healthcare organization; were a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our region. Umpqua Health serves Douglas County Oregon where we prioritize personalized care and innovative solutions to meet the diverse needs of our members. Our comprehensive services include primary care specialty care behavioral health services and care coordination to ensure our members receive holistic integrated healthcare. Our collaborative approach fosters a supportive environment where every team member plays a vital role in our mission to provide accessible high-quality healthcare services. From preventative care to managing chronic conditions were dedicated to empowering healthier lives and building a stronger healthier community together. Join us in making a difference at Umpqua Health.
Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind ensuring that all employment decisions are based on qualifications merit and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment including hiring training promotion and compensation without regard to race color religion gender gender identity or expression sexual orientation national origin genetics disability age veteran status or any other protected category under federal state or local law.
Required Experience:
Exec
Position Title: Senior Director Networking & ContractingDepartment: FinanceStatus: Full Time Exempt positionSchedule: Monday through Friday - 8:00am - 5:00pmLocation: Hybrid position - On-site & remote work requiredSalary: Wage Band 24: $147390 - $200000Only hiring from the state of Oregon preferabl...
Position Title: Senior Director Networking & ContractingDepartment: FinanceStatus: Full Time Exempt positionSchedule: Monday through Friday - 8:00am - 5:00pmLocation: Hybrid position - On-site & remote work requiredSalary: Wage Band 24: $147390 - $200000Only hiring from the state of Oregon preferably applicants residing in Douglas County| POSITION PURPOSE |
| The Senior Director of Network and Contracting provides strategic leadership for Umpqua Healths provider network strategy and oversees all contracting activities to ensure access to high-quality cost-effective care for members. This role is responsible for managing the Provider Relations Credentialing and Contracting/Network Development departments ensuring operational excellence and compliance with regulatory requirements. The Senior Director drives innovative reimbursement strategies including value-based care and bundled payments and fosters strong relationships with providers health systems and payors to support organizational growth and performance. |
| ESSENTIAL JOB RESPONSIBILITIES |
- Define and implement network strategy aligned with organizational goals and regulatory standards.
- Develop innovative contracting and reimbursement models including value-based arrangements and alternative payment structures.
- Provide executive-level guidance on network adequacy and compliance with Oregon Health Authority (OHA) requirements.
- Lead and manage the Provider Relations Credentialing and Contracting/Network Development teams ensuring collaboration and accountability.
- Establish departmental goals performance metrics and continuous improvement initiatives.
- Mentor and develop leadership within departments to build organizational capacity.
- Oversee negotiation drafting and execution of provider contracts including hospitals physician groups and ancillary services.
- Ensure contracts meet financial performance targets and regulatory standards.
- Monitor provider performance and implement strategies to address gaps and inefficiencies.
- Ensure adherence to state and federal regulations including Medicare and Medicaid requirements.
- Support audits reporting and credentialing compliance activities.
- Analyze contract performance and develop strategies to optimize cost and quality outcomes.
- Collaborate with finance and analytics teams to model reimbursement scenarios and forecast financial impact.
- Build and maintain strong relationships with providers health systems and payors to ensure network stability and growth.
- Represent Umpqua Health in external meetings and negotiations as needed.
|
| CHALLENGES |
- Working with a variety of personalities maintaining a consistent and fair communication style.
- Satisfying the needs of a fast paced and challenging company.
|
| QUALIFICATIONS KNOWLEDGE SKILLS AND ABILITIES |
Minimum Qualifications- Bachelors degree in Business Finance Healthcare Administration or related field required; Masters degree preferred. Fifteen year advanced experience will be considered in lieu of degree.
- Minimum 8 years of provider contracting experience in a managed care environment.
- Minimum 3 years of leadership experience managing multiple operational teams.
- Proven experience with value-based contracting and network development strategies.
Knowledge Skills and Abilities- In-depth understanding of managed care provider contracting credentialing and reimbursement methodologies.
- Expertise in Medicare Advantage Medicaid value-based contracting and alternative payment models.
- Advanced negotiation and strategic planning skills.
- Strong leadership and team development capabilities.
- Excellent communication and relationship-building skills.
- Ability to lead multiple departments and complex projects simultaneously.
- Ability to think creatively and strategically to solve problems and drive innovation.
|
| PHYSICAL DEMANDS & WORK CONDITIONS |
- Ability to sit for extended periods and use computer systems for documentation and communication.
- Frequent phone communication and virtual meetings.
- Field work includes home visits in varying environments; must be able to travel locally.
- Home Office Setup: Must have a designated workspace that supports ergonomic standards (desk chair with lumbar support monitor at eye level).
- Noise Level: Moderate typically from phone calls or virtual meetings.
- Technology Requirements: Reliable internet connection computer headset and other necessary peripherals.
- Ergonomic Considerations: Proper posture adjustable seating and monitor placement to prevent musculoskeletal strain. Employers often provide guidelines or stipends for ergonomic equipment
- Environmental Factors: Adequate lighting and ventilation; avoidance of prolonged work in non-ergonomic spaces (e.g. couches or beds).
- Work Hours: Regular predictable attendance in the Pacific time zone.
|
|
| EQUAL EMPLOYMENT OPPORTUNITY |
| UH is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race color sex religion sexual orientation national origin disability genetic information pregnancy or any other protected characteristic as outlined by federal state or local laws. This policy applies to all employment practices within our organization including hiring recruiting promotion termination layoff recall leave of absence compensation benefits training and apprenticeship. UH makes hiring decisions based solely on qualifications merit and business needs at the time. For more information read through our EEO Policy. |
About Umpqua Health
At Umpqua Health were more than just a healthcare organization; were a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our region. Umpqua Health serves Douglas County Oregon where we prioritize personalized care and innovative solutions to meet the diverse needs of our members. Our comprehensive services include primary care specialty care behavioral health services and care coordination to ensure our members receive holistic integrated healthcare. Our collaborative approach fosters a supportive environment where every team member plays a vital role in our mission to provide accessible high-quality healthcare services. From preventative care to managing chronic conditions were dedicated to empowering healthier lives and building a stronger healthier community together. Join us in making a difference at Umpqua Health.
Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind ensuring that all employment decisions are based on qualifications merit and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment including hiring training promotion and compensation without regard to race color religion gender gender identity or expression sexual orientation national origin genetics disability age veteran status or any other protected category under federal state or local law.
Required Experience:
Exec
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Job Location:
Yearly Salary:
USD 147390 - 200000
Posted on:
16 hours ago
Vacancies:
1 Vacancy
