Manager, Contract & Credentialing
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Job Location:
Roseburg, OR - USA
Yearly Salary:
USD 106000 - 118000
Posted on:
9 days ago
Vacancies:
1 Vacancy
Job Summary
MANAGER CONTRACT & CREDENTIALING
HYBRID must be able to travel to 3031 NE STEPHENS ST. ROSEBURG OR 97470
EMPLOYMENT TYPE: Full-Time Exempt
About Umpqua Health
POSITION PURPOSE
The Contractand CredentialingManageris responsible forsupportingservice area agreements with highly visible providers including integrated delivery systems hospitals and physician groups. This role ensures contracts deliver high-quality cost-effective and marketable provider networks that meet organizational standards. The position also manages corporate and network contracts to support strategic goalsand oversight of alldelegated credentialing.
ESSENTIAL JOB RESPONSIBILITIES
- Manage high-priority physician group facility corporate and network contracts in alignment with PADU (Preferred Acceptable Discouraged Unacceptable) guidelines.
- Developnegotiate executeandmaintainprovider contracts within contract management systems.
- Recruit and negotiate with providers to improve network access reduce grievances and support cost control strategies including Medical Loss Ratio (MLR) optimization.
- Maintain effective relationships with key providers and advise Contract Coordinators and Specialists on provider and ancillary contract negotiations.
- Evaluate network performance and implement strategies to ensure compliance with network adequacy standards.
- Ensure contract language meets organizational and regulatory requirements in collaboration with legal counsel.
- Support development of fee schedules and reimbursement models in partnership with Corporate Network Management and legal.
- Educate internal stakeholders on provider contracting processes.
- Participate in strategic initiatives and organizational committees.
- Ensuretimelysubmission of all required contracting related deliverables to the Oregon Health Authority.
- Collaborate with internal departments to gather data and documentation for OHA reporting.
- Oversee and coordinate Network Performance Subcommittee.
- Oversee delegated credentialing entities for compliance.
- Provide leadership and supervision to the Contracting and Network team.
- Perform other duties as assigned
- Working with a variety of personalities maintaining a consistent and fair communication style.
- Satisfying the needs of a fast-paced and challenging company.
- Bachelors degree in a healthcare-related field or equivalent combination of education and experience.
- 57 years of experienceinMedicaidcontractingand healthcarenetwork management.
- Knowledge ofMedicaid Medicare andCommercialhealthcare operations compliance and credentialing processes.
- Strong organizational analytical and problem-solving skills.
- Effective communication and interpersonal skills with the ability to collaborate across teams.
- Ability to manage competing priorities and meet deadlines in a fast-paced environment.
- Accountability:Takes ownership of responsibilities and outcomes.
- Integrity:Maintainsconfidentiality and adheres to ethical standards.
- Innovation:Identifiesopportunities for improvement andimplementingsolutions.
- Collaboration:Works effectively with diverse teams and stakeholders.
- Bilingual translation or translation capabilities a plus
Monday through Friday - 8:00am - 5:00pm; standard business hours with flexibility to meet service timelines.
SALARY
Wage Band 21: $106000- $118000
BENEFITS
- Salary is dependent on skills experience and education
- Generous benefits package including vacation PTO sick leave federal holidays and birthday leave
- Medical dental and vision insurance
- 401(k) with company match (fully vested immediately)
- Company-sponsored life insurance and additional benefits
- Fitness reimbursement program
- Tuition reimbursement and more
Why Umpqua Health
We are committed to advancing health equity by collaborating across communities addressing systemic barriers and ensuring fair access to care and resources. At Umpqua Health every team member plays a vital role in making a meaningful impact empowering healthier lives and strengthening the communities we serve.Inclusive Culture
We foster a respectful inclusive environment where employees feel valued supported and empowered.
Growth & Development
We support ongoing learning through mentorship clear career pathways and professional development opportunities.
Work/Life Balance
We promote flexibility and well-being so employees can thrive both professionally and personally.
Equal Opportunity
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:
Manager
About Company
UMPQUA HEALTH Quality, Local Care for Douglas County Member Services As a member of Umpqua Health, you have access to many different benefits and programs. Whether you’re a new member, or you’ve been with us for years, we’re here to help! Provider Services We’re here to help you deliv ... View more
