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 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 serves as a primary liaison between CareOregon and the provider network, which includes contracted, non contracted, and potential providers. This position focuses on establishing and supporting consistent and reliable provider network relationships. Primary responsibilities include triaging, monitoring, and coordinating provider requests, with a specific foc

This position operates in a team leadership capacity, assisting the supervisor(s) with essential unit functions and serving as the first level escalation and training resource to staff. This position will also support the supervisor(s) in creating and maintaining accurate documentation of policies and procedures. The Lead serves as the example of acting as a primary liais

This position performs senior level accounting functions for the organization. Primary responsibilities include general ledger maintenance, analysis and reporting. This position is also responsible for internal and external relations, auditing, and general administration. Senior accountants are responsible for coding accounts payable invoices and check requests, journal e

This position is responsible for leading the execution of Medicaid and Medicare compliance strategy and activity across the organization. Primary duties include technical and operational planning and oversight, as well as resource, relationship, and people management. This position provides input into strategic plans for the broader organization. Essential Responsibilitie

This position performs data analysis and data visualization 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 evaluatio

Career Opportunities IS Desktop Specialist I (24291) Requisition ID 24291 Posted 05/24/2024 CareOregon Full Time Permanent Portland Multi Location (1) Job Description Print Preview Job Title IS Desktop Specialist I Department Information Systems Exemption Status Non Exempt Requisition # 24291 Direct Reports N/A Manager Title Desktop Support Supervisor Pay & Benefits Estim

Career Opportunities Actuarial Analyst I (24276) Requisition ID 24276 Posted 05/28/2024 CareOregon Full Time Permanent Portland Multi Location (17) Job Description Print Preview Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Position Title Actuarial Analyst I Department Finance Title of

The IS Database Developer III is responsible for defining the direction of database and ETL development, as well as designing and developing effective solutions in support of business strategies. This role is essential toward maturing CareOregon's database and ETL development model. Responsibilities include standard database development or may include a focus on EDI speci