Career Opportunities IS Application Systems Administrator II (24247) Requisition ID 24247 Posted 05/07/2024 CareOregon Full Time Permanent Portland Multi Location (9) Job Description Print Preview Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Position Title IS Applications Systems Admin

Career Opportunities IS Application Systems Administrator I (24263) Requisition ID 24263 Posted 05/08/2024 CareOregon Full Time Permanent Portland Multi Location (9) Job Description Print Preview Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Position Title IS Applications Systems Admini

This position is responsible for proactively identifying opportunities and developing algorithms, models, data structures and data products to facilitate production of insights from healthcare claims, enrollment, and other related data. The core function of this position is to translate complex data into meaningful information for decision makers. Focus areas include cost

This position is responsible for performing compliance monitoring of sub contracted organizations, working collaboratively with departments across CareOregon. Primary responsibilities include delegation oversight, process improvement, and reporting. Essential Responsibilities Delegation Oversight Work at the guidance of and with input from the Regulatory Manager to interp

This position serves as a primary liaison between CareOregon and the provider partner network, which includes contracted, non contracted, and potential providers. This position focuses on establishing, building, and strengthening provider partner relationships among contracted providers. Primary responsibilities include an intermediate level of provider onboarding, develo

This position performs data analysis at an intermediate level. Essential responsibilities are aligned with practices and teams within a defined geographic area, coordinated care organization (CCO), benefit or line of business and may provide guidance to less experienced analysts. This position spends substantial time using a combination of evaluation, quality improvement

This position is responsible for performing a wide variety of financial and actuarial analyses impacting strategic decision making and the company's financial sustainability efforts. Areas of analysis include cost and utilization trend analysis, return on investment evaluations, Medicare bid development, rate setting optimization, forecasting support, benchmarking, risk a

The Senior Pharmacy Clinical Coordinator is responsible for coordinating with staff and providing pharmacy oversight of a line of business (LOB) (i.e., Coordinated Care Organization (CCO)) or the pharmacy network (i.e., clinical and community pharmacists). Responsibilities include developing and delivering clinical and educational interventions designed to improve pharmac

The Medicare Encounter Data Analyst leads the process for the end to end Encounter Data Processing System (EDPS) data flow and works within CMS guidelines for acceptable data submission. Using SQL and SAS programs, monitor submissions of core claims and supplemental data and reconcile against CMS response files. This position influences leadership decision making and prov

This position is responsible for working with CareOregon members, their providers, and pharmacies to support the pharmacy benefit and prescription needs under the major medical benefit. This is an advanced level support position, requiring Pharmacy Technician Certification. Core responsibilities include customer service, claims processing, prior authorizations, formulary

The following job functions are typical of the position but are not all encompassing. Each person is expected to help, to the extent of their abilities, in carrying out whatever work is required to deliver a quality product within budget and on schedule. Maintains and administers assigned technology infrastructure, hardware and software. Installs operating system software

Works under the general direction of a physician or his/her designee, utilizing communication and management skills to coordinate seamless care delivery for patients in a surgical or non surgical setting. Will act as a patient advocate to assure the patient's access to health care during their entry into and through the services of the clinic. Providence caregivers are no

Works under the general direction of a physician or his/her designee, utilizing communication and management skills to coordinate seamless care delivery for patients in a surgical or non surgical setting. Will act as a patient advocate to assure the patient's access to health care during their entry into and through the services of the clinic. Providence caregivers are no

Provide front office services to patients; coordinate surgeries, procedures and deliveries with physician, hospital and patient schedules; perform clerical and records activities in support of patients and staff. Providence caregivers are not simply valued they're invaluable. Join our team at Swedish Health Services DBA Swedish Medical Group and thrive in our culture of p

Works under the general direction of a physician or his/her designee, utilizing communication and management skills to coordinate seamless care delivery for patients in a surgical or non surgical setting. Will act as a patient advocate to assure the patient's access to health care during their entry into and through the services of the clinic. Providence caregivers are no