What are the responsibilities and job description for the Senior Contract Specialist position at CareOregon?

Career Opportunities : Senior Contract Specialist (24827)

verp-client : SMRF Globals
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Enter a list of words, and we\u2019ll search for them in the job title, or you can choose to search for them also within the job description.

Tips : \n \n

We will find results for any words listed

in the search

Results beginning with words searched will also be returned. Ex : A search for \u201cManage\u201d will return \u201cmanage, manager, management\u201d etc.

To find an exact phrase, surround your search phrase with double quotes (\u201d \u201c). Ex : \u201csenior manager\u201d, or check \u2018Exact match\u2019.

Advanced search : \n \n

Use AND, OR, NOT, and () to combine search terms. Ex : Sales AND engineer

finds only jobs that have both terms. \n

Sales OR engineer

finds all jobs that have either.

n (Sales AND Engineer) NOT Manager

finds jobs that contain both \u201cSales\u201d and \u201cEngineer\u201d but not \u201cManager\u201d.

Use question mark (?) for an unknown letter. Ex : Thomps?n finds Thompson, Thompsen, Thompsan, etc.

Use tilde (~) to find similar spellings. Ex : roam~ finds roam, roams, room, road, roads, etc.

Do not use advanced search options if you have checked \u2018Exact match\u2019.

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verp-client : SMRF Globals

function(w){function set(k,v){Object.assign(k==='window'?w : (w[k]=w[k]||{}),v)}set("MSGS",{RECRUITING_CAREERS_SAVED_APPLICATIONS : "Saved Applications",RECRUITING_CONTINUE_WITH_DRAFT_APPLICATION : "Continue",RECRUITING_DRAFT_DELETE : "Delete Application",RECRUITING_DRAFT_OPEN_APPLICATION : "Apply",RECRUITING_DRAFT_SELECT : "Select",RECRUITING_OPEN_NEW_APPLICATION : "Start Over",RECRUITING_OPEN_NEW_APPLICATION_USING_LINKEDIN : "Use LinkedIn\u2122 Profile Data",RECRUITING_PLEASE_SELECT_YOUR_OPTION : " You have an existing job application for this requisition

click \u201cContinue\u201d to use user saved application.

click \u201cStart Over\u201d for a new application (this will delete your saved application).

RECRUITING_SAVED_APP_VS_LINKEDIN_DATA : " You have an existing job application for this requisition

click \u201cContinue\u201d to use user saved application.

click \u201cUseLinkedIn\u2122 Profile Data\u201d for a new application (this will delete your saved application).

window)

verp-client : SMRF Globals

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verp-client : SMRF Globals

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Are you sure you want to continue?",COMMON_DPCS2_Countries : "Countries / Regions",COMMON_DPCS2_DEL_Confirm : "You are about to delete the {0} translation for this statement. All {1} translation data will be lost.

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Requisition ID 24827 - Posted

01 / 29 / 2025 - CareOregon - Full Time - Permanent - Portland - Multi Location (18)

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Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin.

Job Title

Senior Contract Specialist

Exemption Status

Exempt

Department

Contract Management

Manager Title

Value Based Contract Manager

Direct Reports

n / a

Requisition #

24625

Pay and Benefits

Estimated hiring range $88,430 - $108,080 / year, 5% bonus target, full benefits. www.careoregon.org / about-us / careers / benefits

Posting Notes

This is a fully remote role, but you must reside in one of the listed 9 states.

Job Summary

The Senior Contract Specialist is a key contributor to the Contracting team. This position negotiates, develops, and maintains Letters of Agreements (LOAs), and healthcare services contracts which are moderately advanced to complex in nature; may also be responsible for Single Case Agreements (SCA), as assigned. Primary areas of focus include hospital systems and contracts with custom terms. This position also provides analytical, programmatic and project leadership for the department and serves as a resource throughout company for contract language and terms. This position maintains positive, effective relationships with contracted provider network with attention to ongoing service needs, as well as maintains effective relationships with internal departments impacted by contract changes. The Senior Contract Specialist identifies expense outliers, performs financial analysis, and recommends reimbursement strategies.

Essential Responsibilities

Contract and LOA Negotiation and Development

Manage internal contracting process, LOA, and external network relationships for assigned providers and programs.

Negotiate contract language and terms.

Negotiate, coordinate, and produce Letters of Agreement and other provider contract documents.

Build, maintain and leverage effective working relationships with external and internal constituents.

Financial Analysis and Reporting

Perform and review financial analysis with Contract department leadership, Contracting leadership of assigned area and Finance staff.

Perform advanced data gathering, analysis, and reporting in alignment with Contracting policies and procedures.

Lead the development and analysis for key programs and provide recommendations based on analysis.

Assist with the compilation of mandated reporting regarding contract payments.

Contract Administration

Oversee the tracking and monitoring of contracts, LOAs, and related metrics; may also be responsible for SCAs.

Ensure payments are made based on contract terms and assist with the facilitation of those payments as needed.

Ensure all necessary contract information is directed to Provider Services staff for provider data file entry and maintenance.

Assist in the resolution of provider issues related to contractual relationships.

Coordinate accuracy and maintenance of provider payment networks with System Coordinators.

Project Leadership

Provide program and advanced project leadership for assigned area to the Contracting department.

Collaborate with internal departments and leadership to determine appropriate changes to existing programs; participate in the design of new programs and payment models.

Create programmatic materials that educate the provider network and internal teams regarding changes to existing and new payment models.

Department Policies and Operations

Play a critical role in developing and maintaining contract infrastructure and procedures based on management direction.

Recommend provider payment and network strategies to the contract management team.

Orient CareOregon staff to contracting process; act as an advanced resource to staff on contract-related matters.

Organizational Responsibilities

Perform work in alignment with the organization's mission, vision and values.

Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.

Strive to meet annual business goals in support of the organization's strategic goals.

Adhere to the organization's policies, procedures and other relevant compliance needs.

Perform other duties as needed.

Experience and / or Education

Required

Minimum 5 years' progressive experience in managed care contracting, provider relations, network / business development, or financial analysis / accounting with a minimum of 2 years in contract negotiation, development, and administration

Preferred

Bachelor's degree in Business, Health Care Administration, Analytics, or related degree

Knowledge, Skills and Abilities Required

Knowledge

Extensive knowledge of managed care and the Oregon Health Plan

Strong knowledge of federal Medicare regulations and state Medicaid rules (OARs)

Knowledge of claims administration and ability to implement contract reimbursement terms

Knowledge of the Resource-Based Relative Value Scale (RBRVS), Diagnosis Related Groups (DRGs), shared savings agreements, and ability to perform rate calculations

Strong knowledge of data analytics tools and methodologies

Knowledge of physician group, hospital, and facility operations

Skills and Abilities

Excellent analytical skills

Excellent written and verbal communication skills

Strong word processing, spreadsheet, and database skills

Ability to negotiate facility contract language and terms

Ability to develop and maintain effective relationships with providers and provider groups

Ability to achieve desired outcomes through effective use of negotiation skills

Ability to negotiate and implement complex reimbursement arrangements

Ability to maintain professional relationships with internal staff and departments

Ability to independently work with providers, provider groups and other populations in addressing and resolving problems

Ability to work independently, organize, prioritize, and manage multiple projects

Ability to work effectively with diverse individuals and groups

Ability to learn, focus, understand, and evaluate information and determine appropriate actions

Ability to accept direction and feedback, as well as tolerate and manage stress

Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours / day

Ability to hear and speak clearly for at least 3-6 hours / day

Working Conditions

Work Environment(s) : Indoor / Office Community Facilities / Security Outdoor Exposure

Member / Patient Facing : No Telephonic In Person

Hazards : May include, but not limited to, physical and ergonomic hazards.

Equipment : General office equipment

Travel : May include occasional required or optional travel outside of the workplace; the employee's personal vehicle, local transit or other means of transportation may be used.

Li-Remote

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.

Veterans are strongly encouraged to apply.

We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.

Visa sponsorship is not available at this time.

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Salary : $88,430 - $108,080

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