CareOregon

Procurement

• Performing procurement and contracting activities at an entry level
• Administering procurement and contracting software
• Developing and negotiating routine contracts
• Performing contract administration duties
• Helping to ensure quality control and compliance
• Advising and providing technical guidance to internal staff regarding procurement processes
• Developing and drafting solicitation documents
• Facilitating procurement processes to ensure compliance with procurement policies
• Assisting in technical market research
• Evaluating supplier proposals to ensure all requirements are met
• Reviewing, approving, and processing purchasing requests
• Reviewing, drafting, negotiating, and facilitating execution of business contracts and amendments
• Supporting the organization’s mission, vision, and values
• Performing other duties as needed

Procurement and Contract Analyst I

Data Engineer

• Perform Data Warehouse Architecture at an intermediate level
• Focus on design and development of data models and ETL specifications
• Conduct data analysis, system design and architecture
• Propose requirements, standards, and best practices for data modeling
• Conduct product and vendor research, and present recommendations

IS Data Warehouse Architect II

Translator

• Coordinate translation project work of member materials to threshold languages and other languages
• Verify specifications of translation work to be completed; ensure clear and timely communication with vendors
• Track assigned translation projects closely to balance ongoing coordination needs with deadlines
• Monitor translation product quality assurance processes and collaborate with a multidisciplinary team
• Provide suggestions to optimize translation service workflows in support of customer experience
• Update intranet and service sites and respond to policy-related questions as needed

Translation Services Coordinator

Financial Planning and Analysis

• Lead functional administrator tasks for multiple areas within Workday with understanding of cross-functional dependencies
• Interpret needs and develop and guide functional teams on routine to complex business processes and workflows
• Identify and create new calculated fields, rules, validations, alerts, mass operations management (MOM), passive events, custom objects, custom fields, and standard and custom organizations
• Administer reporting intake process; meet with all levels of management to discuss, clarify, interpret, and guide in requests for data
• Maintain data integrity in systems by creating new custom reports or automated alerts to identify and mitigate recurring or critical errors
• Identify risks, configuration options to improve processes, and recommend best practices and mitigations based on Workday functionality
• Develop and oversee technical documentation, such as data dictionaries, glossaries, and procedures for relevant data and reports

Senior Workday Analyst – Finance

Program Manager

• The Regulatory Affairs Program Manager supports the development, oversight, and implementation of regulatory programs
• Provides leadership and expertise across multiple program areas
• Serves as strategic partners to internal departments, facilitating cross-functional enterprise coordination
• Maintains the infrastructure, documentation, and workflows that support regulatory alignment and organizational accountability

Regulatory Affairs Program Manager

Analyst

• Provide system configuration for the organization’s managed care payment system (QNXT) and other core vendor developed systems
• Ensure system configuration consistency across all core applications, including technical scoping, configuration, testing, and implementation
• Participate in the vendor management discipline, supporting long term vendor performance and strategy
• Collaborate with IS team and users for collaboration, analysis, and documentation
• Configure and perform daily software maintenance with oversight
• Participate in objective decision making to maintain data integrity, alignment and usability of applications
• Assist leadership in governance
• Participate in frontend and backend process testing and implementation of new software and software upgrades
• Develop and maintain appropriate configuration documentation

IS System Configuration Analyst II

Data Scientist

• Oversee strategic management and optimization of contracted & non-contracted provider network data
• Ensure comprehensive data collection and quality assurance of provider data
• Facilitate quality improvement projects designed to enhance provider data collection and storage
• Develop and oversee policies and procedures, incorporating best practices

Provider Data Manager

Director

• Lead the execution of payment integrity strategy and activity across the organization
• Direct operational payment integrity activities in support of all lines of business
• Ensure compliance with Federal and state regulatory and contractual requirements
• Prepare and present audit results including root cause and trend analysis
• Establish business cadence to ensure targets are met and/or exceeded
• Develop payment integrity inventory tracking and staff forecasting tools

Director, Payment Integrity

• Oversee and coordinate translation project work of member materials from English to threshold languages and other languages as needed
• Utilize TMS to communicate with translation staff and manage the workflow for all translation projects
• Coordinate the distribution of work to translation staff, contractors, and on-call resources to ensure all translation project deadlines are met
• Monitor translation product quality assurance processes to ensure compliance standards are maintained
• Collaborate with stakeholders, copywriters, graphic designers, project managers, translators, and reviewers to ensure translation quality and branding standards are met
• Provide input into staffing needs; assist in recruiting and hiring staff, using an equity, diversity, and inclusion lens

Translation Services Lead – Bilingual

Risk

• Provide clinical operations support to achieve quality care
• Identify and triage members for appropriate referrals
• Coordinate care across a large regional area
• Support strategic needs of the Care Management Team
• Collaborate with community partners and maintain relationships

High Risk Triage Coordinator – I

IT Support

• working with CareOregon members, their providers, and pharmacies to support the pharmacy benefit and prescription needs under the major medical benefit
• customer service and claims processing
• assistance with prior authorizations, formulary exceptions, appeals, grievances, and projects

Pharmacy Benefit Specialist

Backend Engineer

• Define the direction of database and ETL development
• Design and develop effective solutions in support of business strategies
• Lead the design and maintenance of custom databases and processes
• Develop ETL processes for advanced to complex activities
• Monitor and continually review existing systems to ensure compliance with established standards
• Conduct product and vendor research, and present recommendations to management

Database Developer III

Security Engineer

• Lead the development, implementation, and ongoing improvement of CareOregon’s information security program
• Partner with leaders across the organization to strengthen security governance and reduce risk
• Ensure compliance with regulatory and industry standards and oversee security operations
• Manage incident response, vulnerability management, and third-party risk
• Provide strategic guidance on secure architecture and emerging threats
• Foster collaboration with internal stakeholders and external partners to maintain a resilient security posture
• Develop and report on security objectives and program performance

IS Security Manager

Claims Specialist

• Manage daily operations of the Claims Examiner team
• Assist with work distribution and individual performance tracking
• Measure competency and production levels
• Respond to technical questions from claims examiners
• Assist the supervisor in implementing new processes and procedures
• Perform auditing tasks
• Provide training to internal users on plan benefit matrix and claims policies/procedures
• Process claims and serve as a role model for staff
• Evaluate complex medical, dental, and behavioral health claims
• Provide excellent customer service to internal and external customers
• Document all activities using CareOregon's on-line phone tracking system
• Meet or exceed Department and Company policies including quality and production
• Identify trends and communicate findings and process improvement ideas to the supervisor

Claims Examiner – Lead

Project Manager

• Develop project plans that outline components, communications, milestones, priorities, needs and resources.
• Organize, facilitate, and participate in meetings of stakeholder groups to identify needs and build consensus and collaboration.
• Work collaboratively in analyzing business needs to identify potential technical solutions and process impacts to inform business case and project proposals and project plans
• Apply senior level skills in leading stakeholders; act as a resource to project team members.
• Monitor and regularly communicate project status to Sponsors, Business Owners and other stakeholders, helping to ensure progress toward completion.
• Make formal and informal presentations and reports, providing updates and other relevant information on the status of projects.
• Represent the organization regarding project status and alignment with strategic plans; facilitate and work effectively to develop consensus within divergent groups and/or groups with divergent viewpoints.
• Identify potential difficulties and/or barriers to project goals and take steps to mitigate or avoid them.
• Ensure compliance with all applicable standards, policies, laws, rules and regulations outlined in the project plan.
• Employ advanced change management techniques to facilitate the adoption of the project.
• Track large scale project costs and identify variances from project plans.
• Develop and recommend operational processes and/or process improvements including supporting information systems.
• Maintain appropriate records, information, documentation and reports.
• At the time of project completion, close files and review records to ensure documentation is appropriate and complete.
• Facilitate the evaluation of progress and challenges following implementation, identifying potential system or process improvement opportunities.
• Provide subject matter expertise and guidance for implementation, configuration and on-going support of internal systems, technology, and analytics.
• Perform work in alignment with the organization’s mission, vision, and values.