CareOregon · 1 month ago
Value Based Contracting Manager
Portland Oregon
Full-time
Hybrid
Mid, Senior Level
$124K/yr - $152K/yr
5+ years expCareOregon is seeking a Value Based Contracting Manager to provide leadership to the Value Based Payment contract management team. The role involves managing operational aspects of VBP contracts, collaborating with internal departments, and cultivating relationships with providers to support CareOregon's strategic objectives.
Health Care
Responsibilities
Implement Value Based Payment contracting initiatives that assures CareOregon is strategically positioned to support its current and future provider network and strategic partners
Lead team who is responsible for executing contracts that ensure CareOregon is progressing toward meeting OHA requirements for Value Based Payment, among other strategically aligned contracting initiatives
Work with Contract Specialists in the development and negotiation of contractual and financial arrangements with complex providers (e.g., hospitals, primary care and ancillary providers
Cultivate strong business relationships with provider community
Work collaboratively with internal departments to ensure provider operations are supported by effective, accurate and efficient business processes; reimbursements are accurately defined, communicated and configured; all provider communications are compliant, and reports are accurate, timely and meet all contractual requirements
Oversee development and implementation of contractual terms (including but not limited to reporting and initiatives) with internal teams, including Quality, Legal, IS, among others
Recommend modifications to policy and procedures for entry into data systems for practitioners (including reimbursement) to improve accuracy of payments to CareOregon network
Ensure the satisfactory resolution of operational issues with provider community
Create a unit environment that encourages professionalism and teamwork and uses progressive problem solving to meet expectation
Ensure unit work is performed in coordination with other relevant CareOregon teams
Perform on-going analysis of data and information looking for opportunities for improvement in department operations, including new contract management system
Ensure all applicable Medicaid/Medicare regulations are understood, operationalized, updated and standardized in provider contract templates
Collaborate with internal departments to ensure network adequacy and regulatory reporting obligations are met in a timely and accurate manner for Medicaid/OHA and Medicare/COA LOBs, develop contracting strategies and goals to optimize the network and enhance member access to services. (e.g., Delivery System Network (DSN) and Network adequacy support)
Collaborate with internal departments to further develop contracts based on quality and VBP risk-based components, in line with state requirements and organizational objectives
Lead the development and analysis for key programs, and provide recommendation based on analysis
Collaborate with internal departments and leadership to determine appropriate changes to existing programs, participate in the design of new VBP programs and contract payment models for Medicaid and Medicare
Recommend provider payment and network strategies to leadership and the contract team
Serve as a lead resource to growing contract management staff in the following areas: Negotiation, financial analysis, reimbursement strategies, and alternative payment methodology process
Supervise (or manage) team and recommend team direction and goals in alignment with the organizational mission, vision, and values
Identify work and staffing needs to meet work expectations; recruit and hire, using an equity, diversity, and inclusion lens
Plan, organize, schedule, and monitor work; ensure employees have information and resources to meet job expectations
Lead the development, communication, and oversight of team and individual goals; ensure goals, expectations, and standards are clearly understood by staff
Train, supervise, motivate, and coach employees; provide support toward employee development
Incorporate guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, and decision making
Ensure team adheres to department and organizational standards, policies, and procedures
Evaluate employee performance and provide regular feedback to support success; recognize strong performance and address performance gaps and accountability (corrective action)
Perform supervisory tasks in collaboration with Human Resources as needed
Qualification
Required
Minimum 5 years' experience in provider contracting; experience should include all aspects of contract negotiation, financial analysis, contract implementation and the actual maintenance of the contractual agreement with practitioners (e.g., incentive programs)
Minimum 2 years' experience within a managed care organization or a health care related organization
Project management experience
Process improvement experience
Preferred
Minimum 2 years' experience in a supervisory position or minimum 1 year experience in a supervisory position with completion of CareOregon's Aspiring Leaders Program
Benefits
Medical
Dental
Vision
Life
AD&D
Disability insurance
Health savings account
Flexible spending account(s)
Lifestyle spending account
Employee assistance program
Wellness program
Discounts
Multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.)
Strong retirement plan with employer contributions
PTO
Paid State Sick Time
Paid holidays
Volunteer time
Jury duty
Bereavement leave
Company
CareOregon
Everyone deserves great health care.
501-1000 employees
H1B Sponsorship
CareOregon has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (10)
2023 (3)
2022 (6)
2021 (3)
2020 (2)
Funding
Current Stage
Late StageLeadership Team
Eric C. Hunter
President and Chief Executive Officer
Amy Dowd
COO
Recent News
Behavioral Health Business
2025-09-13
2025-08-29
oregonlive.com
2025-08-13
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