Moda Health jobs in Milwaukie, OR

Job Description Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary The Dental Fraud and Abuse Investigator is responsible for providing accurate and appropriate documentation, research and resolution of written correspondence received from providers and potential Fraud and Abuse investigations under minimal supervision and ensure all resolution letters are in accordance with Delta Dental standards. This is a FT WFH position. Pay Range $25.08 - $28.21 hourly (depending on experience) **Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27768546&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: Bachelor's degree or equivalent work experience. 2 years of experience as a Claim Support or Customer Service Representative preferred Typing proficiency of 25 wpm & 10-key proficiency of 105 kspm net on a computer keypad Demonstrated knowledge of dental terminology, multiple benefit plans, and products. Ability to meet correspondence review timelines. Knowledge and understanding of correspondence and fraud and abuse procedures. Detail oriented and proven initiative, analytical, and problem-solving abilities. Highly effective organizational skills with the ability to prioritize and meet deadlines. Strong reading, verbal, written and interpersonal communication skills. Must be able to work independently, as well as part of a team, dealings with all levels of staff, members, providers, and external customers in a professional manner. Ability to work under pressure and exhibit flexibility in changing priorities. Working knowledge of dental terminology. Proficiency in Moda Health operating systems. Demonstrated proficiency in computer applications such as Word, and Excel. Ability to maintain confidentiality and project a professional business image. Ability to communicate positively, patiently, and courteously. Ability to come into work on time and daily. Primary Functions: Coordinates interpreting contracts/handbooks, and policies and understands overall dental health plan processes. Utilizes guidelines to conduct extensive research and analyzes correspondence and/or fraud and abuse cases pertinent to dental claims to make decisions. Reviews clinical records for completeness and determines if the case is related to an administrative policy or clinical decision. Creates packet for clinical decisions for dental consultants/clinicians to review. Will review all administrative policies to respond directly to those. Independently assesses, investigates, and resolves difficult issues by utilizing company and industry knowledge of operational areas and all established policies and procedures. Organizes the volume of work and maintains a constant caseload. Monitors day to day compliance of cases to ensure that the various state and federal mandated response time frames are met. Communicates in writing or telephone call with members, providers, or attorneys regarding claims and policies about Moda Dental Health benefit plans. Requests additional information such as chart notes or other clinical from providers as needed. Accurately enters all correspondence and fraud and abuse cases into the appropriate tacking systems as needed for various reporting and auditing requirements. Consults with management staff on problem cases and interfaces with interdepartmental personnel in resolving provider correspondence and fraud and abuse questions. Responsible for ensuring the correspondence for fraud and abuse cases are completely resolved which may include reaching out to other departments. Prepares all cases upon receipt of the correspondence or fraud and abuse case. Researches and responds to all dental provider correspondence. Performs all primary functions of a dental claims support processor level II which would include adjusting any claims based on outcome of various types of reviews. Other duties as assigned. Working Conditions & Contact with Others Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need. Internally with dental claims, customer service, membership accounting, and other internal departments. Externally with providers, members, dental consultants, and others. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations please direct your questions to Kristy Nehler or Danielle Baker via our ***************************** email.

RN - Critical Care at Providence Portland Medical Center is a 0.75 FTE part time position working during weekdays and weekends on a night shift. This position is eligible for a sign-on bonus of $8,000. Eligible external hires must meet the required qualifications and conditions for payment. Extra Incentives: Night shift differential - $10.00 p/hr Providence offers a fantastic benefits package which include but is not limited to: Free, convenient, and ample parking TriMet annual pass (Hop Fastpass) for benefit eligible staff who work within the Portland Service Area (does NOT include Wilsonville, Newberg, Seaside, Hood River, Washington State, or Medford) Medical Plan Assistance Program - provides free or reduced-cost coverage to caregivers and their eligible dependents who qualify based on household size and income Tuition reimbursement/education - includes 100% tuition paid program options; up to $5,250 per year for select undergraduate and masters degrees within Guild catalog. Required books and fees are 100% covered or reimbursable for select schools in the Guild catalog up to program funding cap Paid Time Off - Benefit eligible caregivers receive generous PTO accrual allowances Retirement - The Providence retirement program consists of employer match and discretionary contributions that work together with your pre-tax (and/or Roth aftertax) contributions to help you save for retirement. Lyra Caregiver Assistance program - Up to 25 counseling or coaching sessions per eligible member per year (immediate family members are also eligible). Providence nurses are not simply valued - they're invaluable. You will thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best nurses, we must empower them. Learn why nurses choose to work at Providence by visiting our Nursing Institute page. Join our team at Providence Portland Medical Center. As a Providence caregiver, you'll apply your specialized training to deliver world-class health with human connection and make a difference every day through your extraordinary care. Required Qualifications: Graduation from an accredited nursing program. Oregon Registered Nurse License upon hire. National Provider BLS - American Heart Association upon hire. National Provider ACLS - American Heart Association upon hire. 1 year Nursing experience. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About the Team Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 397323 Company: Providence Jobs Job Category: Nursing-Patient Facing Job Function: Nursing Job Schedule: Part time Job Shift: Night Career Track: Nursing Department: 5001 PPMC CRITICAL CARE Address: OR Portland 4805 NE Glisan St Work Location: Providence Portland Medical Ctr-Portland Workplace Type: On-site Pay Range: $55.67 - $81.25 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. PandoLogic. Category:Healthcare, Keywords:Critical Care Nurse, Location:Gresham, OR-97030

Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Job Summary: The Strategic Operations Supervisor oversees the planning and execution of strategic Medicaid initiatives and innovations. This role manages escalated issues, monitors performance, identifies cost-saving opportunities, and leads fiscal and budgetary planning. The Supervisor ensures compliance with federal, state, and contractual requirements; identifies and mitigates operational risks; and supports the quality, efficiency, and integrity of Medicaid program operations. This is a full-time hybrid position based in Portland, Oregon. Pay Range $70,579.27 - $88,224.08 (annually) depending on experience. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27761354&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Primary Functions: Lead Medicaid cost-saving initiatives by analyzing, recommending, implementing, and tracking outcomes across internal departments and external entities. Develop and maintain departmental and executive dashboards and performance metrics, including identifying measurable KPIs for key priorities and initiatives. Articulate strategic visions and translate them into actionable initiatives, offering alternative pathways and solutions when needed. Provide strategic support on projects and deliverables of varying complexity and across stakeholder groups, incorporating feedback and pivoting direction or proposals as needed. Manage competing departmental priorities and coordinate data requests to ensure effective and timely execution. Recommend and implement policies and operational changes that support cost savings, process improvements, and future expansion efforts. Communicate data findings, insights, and strategic recommendations to department leadership, stakeholders, and executive teams. Stay current on and interpret state and federal legislation impacting Medicaid dollars and operations. Conduct local and national market research to identify opportunities for operational innovation. Ensure regulatory compliance while enhancing infrastructure and minimizing operational risk. Support third-party administrator (TPA) business accounts. Travel frequently to Eastern Oregon and other regions across the state. Perform other duties as assigned. Required Skills & Experience: Bachelor's degree in Business Administration, Finance, or a related field, required; Master's degree preferred. Minimum of 4 years of experience in Oregon Medicaid, healthcare operations, or regulatory compliance, with strong knowledge of financial principles and cost management. Proven ability to identify cost savings and implement operational improvements within healthcare systems. Experience with claims pricing, contract configuration, negotiation, and management, including the ability to identify and propose alternative strategies during complex negotiations. Strong project management, organizational, and analytical skills. Proficiency in Microsoft Office, with the ability to create effective reports and dashboards. Skilled in presenting data, proposals, and recommendations to executive leadership and diverse stakeholders. Excellent written, verbal, and interpersonal communication skills for effective cross-functional collaboration. Demonstrated situational awareness, emotional intelligence, and confident leadership in navigating complex or sensitive situations. Track record of innovation, adaptability, and collaboration in dynamic environments. High attention to detail, reliability, and consistent follow-through. Professional appearance and demeanor in all internal and external interactions. Must possess a valid driver's license. Contact with Others & Working Conditions: Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need. Frequent travel. Internally with Medicaid Leadership, including the Board of Directors, Clinical Advisory Panel, and internal departments. Externally with various entities and stakeholders. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our ***************************** email.

Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary We are seeking a Manager of Pharmacy Business Development with a focus on industry relations. The domain expertise to be successful in this role requires foundational clinical pharmacy experience, accompanied by a high degree of business acumen, and an interest and passion for partnering closely with pharmaceutical and biotechnology companies, and other vendor partners who engage in contracting opportunities such as rebate management, and clinical programs. Overall, this position is responsible for development of strategic formulary approaches for the management of medications across the medical and pharmacy benefits, driving to low net cost medication utilization. This position includes reviewing rebate initiatives for medications covered under the pharmacy and medical benefits, across various lines of business including commercial, Exchange, Medicare and Managed Medicaid. The role includes facilitating or supporting the implementation of projects or activities with both external and internal stakeholders and articulating this value as necessary. The ideal candidate resides near or within commuting distance of our Portland, Oregon office to support a hybrid work arrangement, however, remote status will also be considered. Pay Range $134,104.74 - $170,987.17 annually (depending on experience) *This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27766011&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: Doctor of Pharmacy degree (Pharm.D.) preferred, or Bachelors of Pharmacy degree. Current active and unrestricted Oregon Registered Pharmacist license, or eligible for Oregon licensure which is to be obtained within 60 days of employment. Past supervisory experience managing a team. Three to five years of managed care experience, time can be inclusive of training from an accredited managed care residency program. Experience with Commercial, Medicare, and/or Medicaid lines of business. Experience managing contracts, particularly with biopharmaceutical manufacturers and other pharmacy vendors. Technical understanding of pharmacy claims processing information and systems. Strong analytical skills and business acumen. Ability to communicate and present technical information appropriate for the audience. Ability to work independently and collaborate cross-functionally with various stakeholders. Project management skills and the ability to plan and execute projects as assigned. Commitment to service, organization values, and professionalism. Ability to maintain confidentiality and project a professional business image. Works well under pressure with frequent interruptions and shifting priorities. Ability to work independently. Proficient with Microsoft Office applications such as Word, Excel, Outlook, and PowerPoint. Primary Functions: Lead industry relations and rebate strategies for medical and pharmacy benefit medications, and new and emerging therapies, across all lines of business. Oversee all rebate partners and lead evaluations of new potential partners. Identify and negotiate direct contracts with biopharmaceutical partners. Identify, manage, and assess the value of unique vendor partnerships to advance pharmacy programs, including drug information resources, medical management organizations, digital therapeutics, and point of service solutions. Responsible for ensuring compliance with rebate contracts, rebate terms within client contracts, and contracts held with other vendor partners. Lead rebate modeling and optimize rebate scenarios and bid selections based on client specific goals and strategies. Oversee pipeline developments, including market events and material changes to therapeutic categories, for new and emerging therapies, specialty, and traditional medications, and keeps internal and external stakeholders apprised of such events. Develops educational materials as needed. Leads custom formulary rebate offerings and recommendations for downstream clients. In collaboration with other pharmacy leaders, develop enterprise-wide industry relations strategy. Oversee, develop and manage Moda's Industry Relations team. Lead rebate offerings for existing therapeutic strategies which support ongoing formulary performance, but also identify new opportunities either as contracting changes or new market entrants are FDA-approved. Work closely with vendor partners (PBM, medical management companies, others) on policy or formulary changes driven by cost analysis, including rebate considerations or contracting. Support and/or lead client facing presentations within industry relations as necessary. Responsible for information gathering with legal and/or regulatory teams to understand impact to current formulary strategies, with financial implications, to anticipate or plan for any potential compliance driven update due to changes in existing, or new and emerging states of business. Monitor, anticipate changes, and prepare for pipeline and market events. Develop concise, applicable, comprehensive, and timely communiques as assigned for members, providers, internal, or external stakeholders. Provide clinical support services that intersect industry relations or business development, including but not limited to benefit design, formulary analysis, drug information, P&T participation, client support, and drug utilization management. Contribute, update, and maintain policies and procedures related to industry relations. Complete significant projects and performs all other related duties as assigned. Follow the company HR policies, Code of Conduct, and all department policies and procedures including protecting confidential company, employee, and customer information. Working Conditions & Contact with Others Remote, office environment, and/or hybrid with extensive close PC and keyboard work, and constant sitting. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business needs. May require occasional travel to conferences or offsite business meetings. Internally with Clinical Pharmacy, Analytics, Marketing, Sales & Account Services, Actuary & Underwriting, Healthcare Services, Medicare and Medicaid Programs, Benefits, Legal, Regulatory Affairs, and Compliance. Externally with PBM, medical management vendor, pharmaceutical and biotechnology manufacturers, consultants and benefit managers, clients, providers, and pharmacists. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our ***************************** email.

Job Description Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary The Health Promotion and Wellness Consultant will partner with Moda Health's employer groups to consult on high-impact workplace wellness program. The Consultant will identify key strategies to build wellness into company cultures and to maximize employee engagement in workplace wellness programs. Some human capital initiatives include health assessments, health education presentations, interest surveys, needs assessments, and connections to Moda Health and vendor resources - all of which support our clients' organizational health and wellness efforts. This is a FT WFH position. Pay Range $48,900.76 - $61,125.95 annually (depending on experience) *This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27768547&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: Bachelor's degree and two years of experience in wellness, public health, health promotion, health coaching or healthcare preferred. Strong customer service, written & verbal communication skills. Ability to work independently and collaboratively with a team. Thorough knowledge and understanding of health behavior change theory and workplace environmental applications. Strong organizational, time-management, and problem-solving skills, with high attention to detail. Proficiency in Microsoft Word, Excel, Outlook, and Access (data entry forms). Ability to learn proprietary databases. Valid Oregon driver's license. Ability to handle a pushcart/hand truck and to lift boxes up to 40 lbs. in and out of a car trunk. Ability to maintain confidentiality and project a professional business image telephonically and in person. Primary Functions: Serves as the wellness program expert, working with groups to design, implement and evaluate worksite wellness programming, based on Moda's suite of population health and wellness programs. Serves as a liaison between the groups contact and the wellness product, providing ongoing follow up, responding to questions regarding program operations and resolving any issues. Provides basic interpretation of aggregate health risk assessment data, review of utilization reports, discussion of resources. Conducts wellness and health promotion presentations to members and employees, as needed. Works closely with group contacts to coordinate employer-based wellness activities (e.g. biometric screenings, health fairs, and activity incentives) and evaluate program impact. Contributes to the selection, development, implementation, and evaluation of educational materials and other member communications. Reviews and maintains a suite of materials; works with supervisor to identify and request additional resources, as needed. Develops and maintains effective and productive relationships with clients, prospects, vendors, and other Moda Health departments. Perform other duties as assigned. Working Conditions & Contact with Others: Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need. Internally with multiple departments. Externally with clients and vendors. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our ***************************** email.

Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. The Principal Database Administrator works with their team to proactively manage database availability and performance to meet business needs by installing, configuring, monitoring and tuning enterprises databases. Provides expert guidance in tool, methodologies, standards and best practices. The position requires 24/7 on-call support on a rotational bases. Providence Health Plan supports 100% virtual work for residents located in the following areas: + Washington + Oregon + California Required Qualifications: + Bachelor's Degree -OR- a combination of equivalent education and experience + Coursework/Training: Training in relational database management system (RDBMS) administration and a standard SQL language such as T-SQL, PL/SQL, or similar + 7 or more years of industry related experience. Industry related means Information Services, Computer Science, Software Engineering, Database Development, Database Administration, etc + 3 or more years of experience in RDBMS administration in a 24x7 enterprise environment as a senior member of the team + 3 or more years of experience providing technical and/or work process guidance and direction to team members + 3 or more years of experience in architecting database solutions for vendor applications, internally developed application for a variety of database platforms including SQL Server, MySQL or Oracle + 3 or more years of experience in supporting Microsoft Windows Clustering with SQL Server Always ON Availability Groups Preferred Qualifications: + Upon hire: Certifications + Demonstrated advanced experience of Windows and/or Unix Server environments including configuration of ODBC, and JDBC connections + Experience in large databases, supporting OLTP applications, Replication and log shipping technologies + Demonstrated experience in virtual volumes (vVols), SAN/NAS storage systems and related technologies + Experience with Cloud Database technologies such as AWS or Microsoft Azure + Performance Tuning & Optimization - Ability to monitor, troubleshoot, and enhance database performance + System Integration - Experience integrating databases with healthcare applications like Epic[Adams, Cedric] Facets + Access Control & Encryption - Managing user permissions and securing sensitive patient data + Audit & Monitoring - Ensuring data integrity and traceability through regular audits + Data Modeling & Forecasting - Supporting clinical and operational decision-making through data insights + Problem-Solving - Diagnosing and resolving complex database issues efficiently + Stakeholder Engagement - Translating technical concepts for non-technical audiences, including executive leadership + Team Leadership & Mentoring - Guiding junior DBAs and fostering collaboration across IT and clinical teams + Project Management - Leading database-related initiatives and aligning them with organizational goals Salary Range by Location: + California: Humboldt: Min: $63.50, Max: $100.26 + California: All Northern California - Except Humboldt: Min: $71.25, Max: $112.48 + California: Southern California: Min: $63.50, Max: $100.26 + Oregon: Non-Portland Service Area: Min: $56.79, Max: $89.66 + Oregon: Portland Service Area: Min: $60.92, Max: $96.18 + Washington: Western: Min: $63.50, Max: $100.26 + Washington: Southwest - Olympia, Centralia: Min: $60.92, Max: $96.18 + Washington: Clark County: Min: $60.92, Max: $96.18 + Washington: Eastern: Min: $54.21, Max: $85.59 + Washington: Southeastern: Min: $56.79, Max: $89.66 Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About the Team Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 404684 Company: Providence Jobs Job Category: IT Administration Job Function: Information Technology Job Schedule: Full time Job Shift: Day Career Track: Business Professional Department: 5018 IT TECHNOLOGY OR REGION Address: OR Beaverton 3601 SW Murray Blvd Work Location: Murray Business Ctr Beaverton-Beaverton Workplace Type: On-site Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary Receive, track, sort, prepare, and route all incoming mail to various departments. Operate and maintain office equipment, including Opex, Omation, and multiple scanners. Prepare batches for in-house scanning or external processing with Symbeo while maintaining strict turnaround times. Enter member, group and provider information into the system for processing. Prepare daily inventory reports and assist with training on rotational tasks when necessary. Provide coverage for the receptionist desk and phone when required. This is a FT hybrid position based in Milwaukie, Oregon. Pay Range $17 - $17.50 hourly, DOE. **Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27768549&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Schedule: Flexible schedule 8 am - 5 pm Location: 10505 SE 17th Ave, Portland, OR 97222 Requirements: High school diploma or equivalent. At least 6-12 months experience in a production environment preferred. Ability to lift 20+ pounds and work in a fast-paced, physical role. Ability to embrace process improvements and work well in a team-oriented environment. Proficiency with Microsoft Office applications. Typing ability of 35 wpm. 10-key proficiency of 135 kspm. Proficient with prioritizing tasks and completing them with high accuracy and speed. Ability to work well under pressure, with frequent interruptions and shifting priorities. Demonstrates effective reading, writing and oral communication skills. Ability to meet production and quality standards for various types of work and documents. Skilled in handling multiple tasks. Primary Functions: Handle all incoming mail, including inter-office, packages, letters, claims, and certified mail. Sort and prepare medical and dental claims for scanning and vendor handling. Locate, store, rescan, return, or forward claims for further review. Scan paper x-rays. Lift and pull stacks of claims, bins, and mail trays. Track outgoing and incoming claims batches between Moda and Symbeo to ensure compliance and all records are accurate and accounted for. Ensure timely processing of all mail, including scanning, batching, and indexing. Prioritize Medicaid, Medicare, and appeal-related mail to maintain compliance with federal and state regulations. Prepare and batch specialized sorting tasks like medical correspondence, member appeals, and prescription claims. Prepare and distribute daily inventory to Claims Management teams. Keep the mail distribution area clean and organized. Maintain office equipment, including Omation and Opex automatic mail-opening machines and multiple scanners. Enter claims data accurately using Moda systems and ensuring correct member and provider selection while reassigning claims based on dental claims processing guidelines. May write and mail letters to members and providers. Provide relief coverage for the reception desk. Perform other duties as assigned. Contact with Others Internally with various departments. Externally with members, providers, brokers, etc., when covering reception desk. Working Conditions Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business need. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations please direct your questions to Kristy Nehler & Danielle Baker via our ***************************** email.

Physical Therapy Assistant- Providence Home Services Oregon Schedule: Full Time, Days working Monday- Friday Servicing Beaverton Physical Therapy Assistants help provide therapeutic services and activities under the guidance of a Physical Therapist to help patients in need successfully maintain or improve their level of independence. Working in Home Health provides the unique opportunity to care for your patients where they are most comfortable. Join our team to create rewarding relationships with a diverse patient population while exercising independence and flexibility with your career. Benefits and perks: + Competitive pay (including holiday pay & shift pay differentials) + Best-in-class benefits - full medical, dental and vision coverage from your first day + 401(k) plan with employer matching & complementary retirement planner + Generous paid time off for vacation, sick days and holidays + Mileage reimbursement for roles traveling to patient homes + Tuition reimbursement & student loan forgiveness programs + Wellness & mental health assistance programs + Back-up child & elder care to help with care disruptions for your family + Voluntary benefits, like pet, auto and home insurance, and more! Required Qualifications: + Associate's Degree Physical Therapy, from an accredited program. + Within 30 days of hire: National Provider BLS - American Heart Association + Upon hire: Oregon Physical Therapy Assistant License + Upon hire: Washington Physical Therapist Assistant License (Vendor Managed) - if practicing within this state Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About the Team Providence Home and Community Care (HCC) is a service line within Providence with over 8,000 caregivers and 2,000 volunteers serving nearly 200,000 people a year, in their homes, in clinics and in a variety of congregate living ministries across our seven-state footprint. HCC provides a full range of services and support for people of all ages, especially those facing chronic or life-limiting illnesses. Our core competencies include restorative care, longitudinal care and care through the end of life. Our service lines include assisted living/skilled nursing/rehabilitation, home health, home infusion/pharmacy services, home medical equipment, hospice and palliative care, Program of All-Inclusive Care for the Elderly (PACE), personal home services/private duty care and supportive housing. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 393401 Company: Providence Jobs Job Category: Rehabilitation Job Function: Clinical Care Job Schedule: Full time Job Shift: Day Career Track: Clinical Support Department: 5015 HH OR WEST PORTLAND Address: OR Beaverton 3601 SW Murray Blvd Work Location: Murray Building - Home Service West Portland Workplace Type: On-site Pay Range: $30.15 - $46.13 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

The Role This person can work within our Providence footprint (WA, OR, CA, MT, TX, AK, NM) The Senior Corporate Counsel position is responsible, under the guidance of Department of Legal Affairs (DLA) Leadership, for providing valued, strategic, and practical legal advice and support for Providence St. Joseph Health ("Providence") in a wide range of complex mergers and acquisitions, and healthcare transactions, including joint ventures, affiliations, partnerships, divestitures, and other healthcare-related business arrangements. The candidate will provide expert, strategic, and solutions-focused legal counsel on a broad range of complex transactions across Providence's multi-state system. This senior attorney partners closely with executive leadership, corporate development, finance, operations, compliance, and other stakeholders to structure, evaluate, negotiate and execute transactions that support Providence's business objectives and Mission. The role requires substantial experience managing complex transactions end-to-end, a high degree of independent judgement, and the ability to lead cross-functional teams through time critical matters. Key Position Responsibilities + Serve as lead transactions counsel on a wide variety of complex healthcare transactions, including mergers, acquisitions, divestitures, joint ventures, strategic affiliations, dispositions, and internal reorganizations. + Draft, negotiate and manage end-to-end transaction documents, including purchase agreements, joint venture agreements, operating agreements, governing documents (e.g., articles, bylaws, etc.) and ancillary transaction documents in compliance with applicable statutes, regulations, and policies, and in accordance with relevant legal relationships. + Structure transactions in alignment with Providence's priorities, while anticipating and mitigating legal, regulatory, and business risks. + Advise senior executives and internal business partners on transaction strategy, risk management, deal structure, diligence findings, and negotiation positions. + Work closely with internal stakeholders, including finance, operations, and compliance, to structure and execute transactions that align with business objectives. + Oversee and coordinate legal due diligence across multiple workstreams in connection with corporate transactions. + Identify, assess and clearly communicate material risks, regulatory constraints, and deal-critical issues. + Ensure transactions comply with federal and state healthcare regulatory requirements, nonprofit legal obligations, and internal policies. + Collaborate within DLA to streamline the delivery of legal services; provide consistent, effective legal advice; and manage legal resources. + Manage outside counsel efficiently and strategically on major transactions to ensure cost efficiencies, and positional consistency and support. + Function independently with respect to highly complex contracts and transactions. + Assumes responsibility for administrative functions within DLA, as assigned. Qualifications + Juris Doctor degree from an accredited law school. + Active admission and license to practice law in either California or Washington or willingness to obtain license in either of those states). + At least 10 years of relevant experience (some law firm experience is a plus) with a focus on transaction, commercial contracting, and healthcare-related matters preferred. + Strong proficiency in drafting and negotiating agreements related to mergers and acquisitions, corporate finance transactions, joint ventures, strategic alliances, and internal reorganizations. + Experience with entity formation, corporate finance, health care organizations, for-profit as well as non-profit transactions preferred. + Strong drafting, negotiation and analytic skills. + Ability to recognize and weigh business and legal risks, think strategically and advance practical solutions. + Ability to provide sound and practical advice on legal and business matters in a complex, fast-paced environment to a broad range of business teams. + Superior drafting skills, especially the ability to draft contract language that is clear, concise, and easily understood, creating templates and processes to improve efficiency of the contract review process. + Superior communication skills in both written and verbal presentation, including all aspects of legal writing technique and procedure, and the ability to convey complex legal concepts to non-lawyers. + Ability to function effectively and complete projects in a timely manner in a fast-paced environment. + Ability to work collaboratively with attorneys and staff within DLA and Providence. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. Requsition ID: 393485 Company: Providence Jobs Job Category: Legal Job Function: Legal/Compliance/Risk Job Schedule: Full time Job Shift: Day Career Track: Leadership Department: 4015 SS LEGAL Address: WA Seattle 800 Fifth Ave Work Location: Swedish Bank Of America Bldg-Seattle Workplace Type: Hybrid Pay Range: $280K - $350K The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Job Description Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary The Healthcare Data Analyst is a critical resource in our efforts to manage health care costs, improve quality, and enhance the experience of both the member and the care team, through sophisticated analysis and communication of health care data. This is a FT WFH role. Pay Range $70,579.27 - $88,224.08 annually (depending on experience). *This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27765790&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: Bachelor's degree or equivalent experience. Minimum 3-5 years' experience in financial analysis or other data analysis role. Experience with health care data preferred. Demonstrated ability to use data to influence organization strategy, workflows, or results Strong analytical and problem solving skills Strong verbal, written and interpersonal communication skills. Experience with using data analysis tools such as SAS, SQL, Microsoft Access, Business Objects, Crystal Reports, or other similar applications. Strong Microsoft Excel skills. Ability to work well under pressure and with constantly shifting priorities. Ability to project a professional image and maintain complete confidentiality. Primary Functions: Under general supervision, performs complex research and analysis of healthcare claims, enrollment, and other related data, to report on network utilization, cost structure, and/or quality. Combines and transforms data from multiple tables, databases, and/or systems. Has a high level of understanding of data sources, flow, and limitations. Is able to develop reports and processes that appropriately integrate data from multiple sources. Evaluates, writes, presents, and provides recommendations regarding healthcare utilization, quality measure, and cost containment reports. Meets with internal customers to brainstorm what kind of information/report is needed for each situation. Thinks creatively about how to solve a problem or meet a specific business need, given the data available. Makes presentations to internal & external stakeholders about health care cost and utilization. Presents data in a compelling way that highlights the opportunities at hand - whether in making comparisons to benchmarks, pointing out anomalies, displaying trends over time, or using other creative analytical tools. Collaborates with the other members of the Analytics team to expand analytical capabilities, methods, and toolkits. May provide guidance or expertise to less experienced analysts. Other Duties as assigned Working Conditions: Prolong keyboard and PC work in a constant seated position. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business need. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our ***************************** email.

Calling all Esteemed Leaders! Are you a strategic mastermind with a passion for healthcare? Do you thrive on navigating complex challenges and shaping the future of healthcare delivery? If so, then we have the perfect opportunity for you! You can be based in Oregon, Washington or California. The Role: As the Director of Underwriting for Providence Health Plans, you will be a pivotal force in developing strategies and policies to support profitable membership growth, retention, business expansion, and diversification in accordance with long-range plans. You will provide clear vision, direction, and consistency in risk analysis, planning, organizing, developing, implementing, evaluating, and auditing underwriting activities and models across all regions. You will identify risks related to the introduction of new products or modification of underwriting requirements and represent the Plan alongside Sales to promote pricing transparency to Producer partners and employer groups, substantiating and providing credibility around pricing decisions. What You'll Do: + Strategic Architect: Collaborate with Plan leaders to create and implement strategies and policies that support product development efforts, profitable growth, special risk arrangements, business expansion, and diversification according to the long-range plan for fully insured commercial business. + Performance Guide: Lead development, monitoring, and achievement of department service level standards, fostering high-performance relationships with Sales, Pharmacy, Product, and Actuarial departments. + Underwriting Leader: Direct all rating and underwriting activities for all new and renewing fully insured large group and Association Health Plan commercial group lines of business, ensuring financial performance and development of associated pricing models. + Transparency Advocate: Represent the Plan alongside Sales Leadership, promoting pricing transparency to Producer partners and employer groups, substantiating and providing credibility around pricing decisions. + Compliance Champion: Ensure adherence to underwriting audits, processes, guidelines, and procedures consistent with State and Federal Law and regulatory requirements. + Collaborative Innovator: Work with Actuarial and Finance Directors to routinely update and test rates and factors in the underwriting models, ensuring alignment with industry best practices and strategic objectives. + Talent Developer: Mentor and coach the Underwriting Manager and staff, attracting top industry underwriting talent and fostering development and engagement within established authority levels. + Budget Strategist: Oversee the development and achievement of the Underwriting Department's annual budget. What You'll Bring: + Educational Background: Bachelor's Degree in Finance, Mathematics, or a related field; Master's Degree in Business Administration preferred. + Experience: 10 or more years of experience in healthcare underwriting, with 5 years in a Leadership role and 2 years leading teams through promoting teamwork, decision-making, delegation, training, and coaching. + Analytical Expertise: Exceptional quantitative and problem-solving skills, with a thorough understanding of insurance underwriting and rating methodologies. + Strategic Mindset: Ability to work with senior management to quickly solve difficult strategic questions. + Technical Proficiency: Strong skills in spreadsheet, statistical, and database software packages. + Communication Mastery: Excellent written, verbal, listening, negotiation, presentation, and math skills. + Project Management Skills: Ability to maintain positive relationships with critical areas while achieving department objectives. Why Join Us? + Make a Real Difference: Be part of an organization that transforms healthcare and improves countless lives. + Unleash Your Potential: Enjoy the autonomy and support needed to bring innovative ideas to life. + Work with the Best: Collaborate with a team of talented and dedicated professionals passionate about their work. + Thrive in a Dynamic Environment: Embrace the challenges and rewards of a fast-paced, ever-evolving industry. Ready to Shape the Future of Healthcare? If you're a visionary leader with a passion for healthcare, we encourage you to apply! Join our team and help us create a healthier future for all. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. Requsition ID: 394481 Company: Providence Jobs Job Category: Underwriting Job Function: Finance Job Schedule: Full time Job Shift: Day Career Track: Leadership Department: 5018 SALES UNDERWRITING OR REGION Address: OR Portland 4400 NE Halsey St Work Location: Providence Health Plaza (HR) Bldg 1-Portland Workplace Type: Remote Pay Range: $76.29 - $121.96 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary We are seeking a clinical pharmacist with a focus on industry relations. The domain expertise requires both foundational clinical pharmacy experience alongside an interest and passion for partnering closely with pharmaceutical and biotechnology companies, and other vendor partners who engage in contracting opportunities such as rebate management, and clinical programs. Overall, this position is responsible for supporting formulary and policy development, driving to the lowest net cost which are supported by our clinical strategies, and articulating this value as necessary to key stakeholders. This position includes reviewing rebate initiatives for medications covered under the pharmacy and medical benefits, across various lines of business including commercial, Exchange, Medicare and Managed Medicaid. The role includes facilitating or supporting the implementation of projects or activities with both external and internal stakeholders. The ideal candidate resides near or within commuting distance of our Portland, Oregon office to support a hybrid work arrangement, however, remote status will also be considered. Pay Range $111,640.18 - $142,337.61 annually (depending on experience) *This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27765265&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: Doctor of Pharmacy degree (Pharm.D.) preferred. Current active and unrestricted Oregon Registered Pharmacist license, or eligible for Oregon licensure which is to be obtained within 60 days of hire date. Two to three years of managed care experience or training from an accredited managed care residency program. Strong analytical skills and business acumen. Ability to communicate and present technical information appropriate for the audience. Ability to work independently and collaborate cross-functionally with various stakeholders. Project management skills and the ability to plan and execute projects as assigned. Commitment to service, organization values, and professionalism through appropriate conduct and demeanor always. Ability to maintain confidentiality and project a professional business image. Works well under pressure with frequent interruptions and shifting priorities. Strong written and verbal communication skills. Proficient with Microsoft Word, Excel, Outlook, and PowerPoint. Primary Functions: Obtain and review rebate offerings for existing therapeutic strategies which support ongoing formulary performance but also identify new opportunities either as contracting changes or new market entrants are FDA-approved. Work closely with vendor partners (PBM, medical management companies, others) on policy or formulary changes driven by cost analysis, including rebate considerations or contracting. Request and identify medical and pharmacy rebate management across all lines of business (i.e. commercial, Exchange, Managed Medicaid, custom clients, and Medicare as needed). Support and/or lead client facing presentations within industry relations as necessary. Responsible for information gathering with legal and/or regulatory teams to understand impact to current formulary strategies, with financial implications, to anticipate or plan for any potential compliance driven update due to changes in existing, or new and emerging states of business. Monitor, anticipate changes, and prepare for pipeline and market events. Develop concise, applicable, comprehensive, and timely communiques as assigned for members, providers, internal, or external stakeholders. Provide clinical support services that intersect industry relations or business development, including but not limited to benefit design, formulary analysis, drug information, P&T participation, client support, and drug utilization management. Provide clinical expertise with a focus on industry relations to all key stakeholders, including Senior Rx Program Analyst, Clinical Pharmacy, Benefits, within or outside of pharmacy. For example, specific to analyst level support, provide clinical expertise for indication-based dosing and defining therapeutic landscape. Contribute, update, and maintain policies and procedures related to industry relations. Lead as needed, from both a clinical pharmacy and industry relations perspective, weekly drug compendia formulary management file. Complete significant projects and performs all other related duties as assigned. Follow the company HR policies, Code of Conduct, and all department policies and procedures including protecting confidential company, employee, and customer information. Working Conditions & Contact with Others Remote, office environment, and/or hybrid with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business needs. May require occasional travel to conferences or offsite business meetings. Internally with Clinical Pharmacy, Marketing, Sales & Account Services, Actuary & Underwriting, Healthcare Services, Customer Service, Information Technology, Benefits, Regulatory Affairs, Legal, and Membership Accounting. Externally with PBM, medical management vendor, pharmaceutical and biotechnology manufacturers, producers, benefit managers, clients, providers, and pharmacists. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our ***************************** email.

Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary The Health Promotion and Wellness Consultant will partner with Moda Health's employer groups to consult on high-impact workplace wellness program. The Consultant will identify key strategies to build wellness into company cultures and to maximize employee engagement in workplace wellness programs. Some human capital initiatives include health assessments, health education presentations, interest surveys, needs assessments, and connections to Moda Health and vendor resources - all of which support our clients' organizational health and wellness efforts. This is a FT WFH position. Pay Range $48,900.76 - $61,125.95 annually (depending on experience) *This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27768547&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: Bachelor's degree and two years of experience in wellness, public health, health promotion, health coaching or healthcare preferred. Strong customer service, written & verbal communication skills. Ability to work independently and collaboratively with a team. Thorough knowledge and understanding of health behavior change theory and workplace environmental applications. Strong organizational, time-management, and problem-solving skills, with high attention to detail. Proficiency in Microsoft Word, Excel, Outlook, and Access (data entry forms). Ability to learn proprietary databases. Valid Oregon driver's license. Ability to handle a pushcart/hand truck and to lift boxes up to 40 lbs. in and out of a car trunk. Ability to maintain confidentiality and project a professional business image telephonically and in person. Primary Functions: Serves as the wellness program expert, working with groups to design, implement and evaluate worksite wellness programming, based on Moda's suite of population health and wellness programs. Serves as a liaison between the groups contact and the wellness product, providing ongoing follow up, responding to questions regarding program operations and resolving any issues. Provides basic interpretation of aggregate health risk assessment data, review of utilization reports, discussion of resources. Conducts wellness and health promotion presentations to members and employees, as needed. Works closely with group contacts to coordinate employer-based wellness activities (e.g. biometric screenings, health fairs, and activity incentives) and evaluate program impact. Contributes to the selection, development, implementation, and evaluation of educational materials and other member communications. Reviews and maintains a suite of materials; works with supervisor to identify and request additional resources, as needed. Develops and maintains effective and productive relationships with clients, prospects, vendors, and other Moda Health departments. Perform other duties as assigned. Working Conditions & Contact with Others: Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need. Internally with multiple departments. Externally with clients and vendors. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our ***************************** email.

Sterile Processing Technician at Providence St Vincent Medical Center - Full-Time, Day Schedule is Monday to Friday, 2:30-11 Want to know what it's like working at Providence? Click HERE _Providence offers a fantastic benefits package which include but is not limited to:_ Free, convenient, and ample parking TriMet annual pass (Hop Fastpass) for benefit eligible staff who work within the Portland Service Area (does NOT include Wilsonville, Newberg, Seaside, Hood River, Washington State, or Medford) Medical Plan Assistance Program - provides free or reduced-cost coverage to caregivers and their eligible dependents who qualify based on household size and income Tuition Reimbursement/Education - includes 100% tuition paid program options; up to $5,250 per year for select undergraduate and master's degrees within Guild catalog. Required books and fees are 100% covered or reimbursable for select schools in the Guild catalog up to program funding cap Paid Time Off - Benefit eligible caregivers receive up to 25 days per year Retirement - The Providence retirement program consists of employer match and discretionary contributions that work together with your pre-tax (and/or Roth aftertax) contributions to help you save for retirement. Lyra Caregiver Assistance Program - Up to 25 counseling or coaching sessions per eligible member per year The Tech-Sterile Processing 1 is responsible for the effective cleaning, inspection, maintenance, proper sterilization and distribution of sterile instrumentation and equipment. Works collaboratively with other departments to ensure all supplies, instrumentation and equipment are available for surgical cases as well as other procedures requiring sterile supplies and/or instrumentation. Is knowledgeable in sterile processing standard and serves as a patient safety advocate. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence St Vincent Medical Center and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: Coursework/Training: Successful completion of a sterile processing course., Or 1 year of healthcare experience. Within 18 months of hire: National Certified Registered Central Service Technician - Healthcare Sterile Processing Association, Or Within 18 months of hire: National Certified Sterile Processing and Distribution Technician - Certification Board for Sterile Processing and Distribution Experience using personal computer and basic software programs. Preferred Qualifications: 1 year - Sterile processing experience. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About the Team Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 404870 Company: Providence Jobs Job Category: Surgical/Perioperative Services Job Function: Clinical Care Job Schedule: Full time Job Shift: Evening Career Track: Clinical Support Department: 5002 PSVMC STERILE PROC Address: OR Portland 9205 SW Barnes Rd Work Location: Providence St Vincent Medical Ctr-Portland Workplace Type: On-site Pay Range: $20.19 - $30.26 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Job Description Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary The Software Engineering Manager will supervise a team of skilled developers responsible for building, integrating, and supporting critical web-based systems serving both internal and external customers and business partners. Applications include online portals, sales and marketing tools, intranet collaboration, and customer support services. Directly reporting to this role are software engineering managers for each of the development teams. The development team includes software engineers focused on developing solutions using Java, .Net, JavaScript, Web Services, and Content Management Systems. You will collaborate with business teams and IT stakeholders to determine and implement online solutions which support Moda Health's goals. This is a FT WFH position. Pay Range $113,543.26 - $147,602.10 annually (depending on experience) *This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27766416&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: Bachelor's degree or equivalent specializing in Computer Science or a related field. Minimum of five (5) years of experience programming or managing the development of web applications using Java or .Net technologies. Extensive understanding of web technologies, software engineering, and programming languages. Ability to keep current with emerging internet technologies. Solid background in client/server programming and relational database systems. Outstanding analytical, problem-solving, organizational, and detail orientation skills. Strong ability to negotiate, prioritize, determine tasks, and allocate resources. Ability to work well under pressure, work with frequent interruptions, and shifting priorities. Maintain confidentiality and project a professional business image. Demonstrated ability to manage customer escalations. Willingness to work additional or non-standard hours when necessary. Primary Functions: Oversees and coordinates activities for a single web development team, including but not limited to, hiring, monitoring performance, training, coaching, and mentoring. Makes recommendations for processes and policies used to develop systems and services. Effectively communicate project status, project goals, and milestones to customers as needed. Provides guidance, estimates, and recommendations on system development, Supervises the creation, update, and maintenance of system support documentation. Effectively collaborate with internal and external stakeholders to identify and prioritize project deliverables. Ability to project a professional business image and maintain confidentiality. Perform other duties and responsibilities as assigned. Working Conditions: Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our ***************************** email.

Job Description Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary As a Medical Claims Operations Assistant, you will support the daily operations that help Moda deliver timely and accurate claims services. Responsibilities include organizing incoming mail, preparing documents for imaging, updating tracking tools, and assisting with departmental correspondence and administrative tasks. This position is ideal for someone who enjoys detail-focused work and takes pride in supporting reliable processes that benefit our members and providers. Additional responsibilities include ordering and maintaining supplies, ensuring the supply room is organized, and assisting with special projects as needed. This is a fully on-site position based in Milwaukie, Oregon. Pay Range $17.00 - $18.55 hourly, DOE. *Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27765792&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: High school diploma or equivalent. At least 6-12 months' experience in a production environment is preferred. Ability to lift 50+ pounds and work in a fast-paced, physical role. Ability to embrace process improvements and work well in a team-oriented environment. Strong proficiency with Microsoft Office applications. Typing ability of 35 wpm. 10-key proficiency of 135 kspm. Strong organizational skills and attention to detail. Proficient with prioritizing tasks and completing them with high accuracy and speed. Ability to work well under pressure, with frequent interruptions and shifting priorities. Demonstrates effective reading, writing and oral communication skills. Ability to meet production and quality standards for various types of work and documents. Skilled in handling multiple tasks. Primary Functions: Handle all incoming mail, including inter-office, packages, letters, claims, and certified mail. Scan and index incoming mail at the printer or compile documents to send to Imaging. Receive and send facsimile submissions and distribute accordingly. Work assigned imaging application queues. Write and mail letters to members and providers. Examine claims to determine if further investigation is needed from the Hospital Audit department, request itemizations of services from providers, mail outgoing letters, and route claims appropriately through the claims processing system. Manage and update multiple tracking spreadsheets for claim audits and follow-up tasks. Processes voided checks. Issues follow up correspondence letters as needed. Communicate via telephone with providers and facilities. Responds and follows up using Facets, Content Manager, E-mail and Teams. Responsible for ordering, maintaining supplies and ensuring supply room is properly stocked and organized. Provide assistance to Medical Claims department as needed for special projects. Other duties as assigned. Working Conditions & Contact with Others: Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens and system applications simultaneously. Inside the company with own claims department staff, Imaging Department, Facilities, and other as required. Internally with Claims, Customer Service, Healthcare Services, Membership Accounting, Information Technology, and Professional Relations. Externally with Providers/Facilities, Vendors, and Insurance companies. Primary communications will be with the team of RN Hospital Auditors. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations please direct your questions to Danielle Baker & Kristy Nehler via our ***************************** email.

Seeking a full-time board-certified/board-eligible Dermatologist at Providence Medical Group (PMG) Dermatology in the Portland, Oregon Metro area. PMG Dermatology is a well-established group of 20 Dermatologists and 1 Mohs surgeon. There are 5 clinics throughout the Portland Metro area. There is an open position at the PMG Reed's Crossing Dermatology location, about 10 miles from downtown Portland in Hillsboro. The physicians, department leadership and clinic operations teams work closely together to foster a culture of excellence. The team is committed to high quality patient care and a sustainable and joyful work environment. They consistently earn top scores in patient satisfaction as well as physician and staff engagement. Enjoy outstanding quality of life in the beautiful Pacific Northwest, with mountain snow, ocean beaches and the Willamette Valley wine country close by. Position Details: + Open position for either 0.75 FTE (3 days per week) or 1.0 FTE (4 days per week), with 8.5 hours per day of patient care + Scheduled 15-minute appointments for regular office visits and 30 to 60 or 45 minutes for procedure appointments based on physician preference + Flexibility in designing your schedule template + Option to do cosmetic treatments + Option to read some or all of your own Dermatopathology + Narrowband UVB phototherapy and photodynamic therapy available on site Compensation & Benefits: + Guaranteed salary base for 1.0 FTE (pro-rated for 0.75 FTE) + Production bonus with bi-weekly compensation calculated based on a rolling 4-month average of wRVU production. You could expect to increase your base salary by 75+% after 4 months of a full schedule + CME allowance of $6000 and 80 hours per year for 1.0 FTE + Starting bonus and relocation assistance offered + Comprehensive benefit package including Paid Time Off (26.4 days per year for 1.0 FTE), Health, Dental, Vision, Life, Disability, and Malpractice Insurance + As a non-profit organization, Providence is an eligible employer for the Public Service Loan Forgiveness (PSLF) program Qualifications & Requirements: + New graduates are welcome to apply Where You'll Work Providence Medical Group is an organization of employed physicians, with more than 90 clinics across the state of Oregon. Its 1,500+ providers possess a wide range of clinical expertise, including Family and Internal Medicine, Infectious Disease, Dermatology and Occupational Medicine. At Providence Medical Group, patients enjoy close-to-home access to dedicated providers in primary, specialty or urgent care clinics, with clinical and operational support from centralized Providence programs. Where You'll Live In Portland, Oregon, you'll find a perfect blend of urban excitement and natural beauty. Home to the Portland Trail Blazers, "Rip City" offers residents endless entertainment, with eclectic art and culinary scenes, sports culture and distinct neighborhood identities. Nestled between the Willamette and Columbia rivers, and just a drive away from Mt. Hood, the Columbia Gorge and the Oregon Coast, Portland offers unparalleled, year-round access to outdoor adventures. Who You'll Work For Providence is a nationally recognized, comprehensive healthcare organization spanning seven states with a universal mission - to provide compassionate care to all who need its services, especially the poor and vulnerable. Its 122,000-plus caregivers/employees (including 34,000 physicians) serve in 51 hospitals, more than 1,000 clinics and a comprehensive range of health and social services. Providence: One name, one family, one extraordinary health system. Check out our benefits page for more information. Equal Opportunity Employer including disability/veteran _Job ID Number: 29961_ _Facility Name: Providence Medical Group - Oregon_ _Location Name: Portland_ _Brand Name: Providence_ _Provider Profession: Physician/Surgeon_ _Medical Specialty: Dermatology_ _Job Setting: Medical Clinic_ _Type of Role: Clinical_ _Email: *******************************_ _Phone Number: **************_ _Schedule: Full Time_ _CP: Yes_ _CB: Yes_ _NP:_ _PA:_ _HC: Yes_ _IS: No_ _YM: Yes_ _J1: No_ _H1B: No_ Let's get in touch If you have questions about this specific job or others, I'm all ears. Send me a note and we'll be one step closer to the right opportunity. Heather Mitchell Provider Recruiter ************** ******************************* Contact Me

Job Description Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary This position will provide support to the Medical Management team by assisting in the investigation and research of prior authorization requests. Completes reviews or support the clinical staff in the review processes by preparing or completing the requests as assigned. This is a temporary WFH role. Pay Range $20.88- $23.49 hourly (depending on experience). Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27767811&refresh=true Benefits: Medical, Dental, Vision & Pharmacy PTO and Company Paid Holidays 401k - Matching Required Skills, Experience & Education: High school education or equivalent. 1-2 years of experience in a medical office and/or insurance experience needed. Proficient with PC and Microsoft Office applications. Type a minimum of 35 wpm and 10key proficiency of 135spm on computer number keypad. Excellent written, verbal, and interpersonal communication skills including demonstrated business writing and grammar skills. Excellent organizational and detail orientation skills. Must present a professional business image in all settings. Ability to work well under pressure, work with frequent interruptions and shifting priorities. Ability to come to work on time and daily. Ability to work independently, as well as part of a team, dealing with all levels of staff, members, providers, in a professional manner. Ability to maintain confidentiality. High level of understanding of medical terminology and coding, state and federal regulations for claims adjudication and provider contracting. Knowledge of Health Plan benefits. Ability to interpret complex benefit packages and contract language. Strong problem-solving skills and decision quality preferred. Familiar with CMS (Medicare) rules and regulations a plus but not required. Primary Functions: Determines the requirement for prior authorization based on the plan type, ICD-10 code, CPT/HCPC code or place of service. Review and research referral and authorization requests received in Healthcare Services. Process or route per appropriate guideline. Provides education to members and providers regarding prior authorization process. Interacts with providers and provider offices to gather complete, accurate information to process prior authorizations and referrals and coordinates with providers to ensure consideration is given to unique treatment. Consults the RN, Manager or Supervisor on complex cases. Responsible for daily administrative functions of the clinical team in Healthcare Services, ensuring deadlines are met to support required processes of the clinical team, members and providers as well as facilitates the timely processing of documentation submitted to the Medical Management department. Utilizes the Moda Health systems for documentation of contact with providers and members. Communicates effectively with other Medical Management support staff. Analyze claims and encounters according to the limits of authorization, benefit plan and provider contracts. Effectively uses the Moda Health systems to accurately determine eligibility, benefit plan, and physician networks associated with the member's plan. Completes approvals, and denials by the medical director, of claims and prior authorization requests in a professional, positive manner. Send proper correspondence to providers, members, and other departments to either obtain additional information necessary for the review of claims or denial of requested services. Analyze authorizations for correct information, such as authorization maximums, limitations, and special instructions for performance groups. Ensure adherence of Health Insurance Portability and Accountability Act (HIPAA) and other regulatory guidelines including privacy and security. Responsible for the auditing of individual daily work for accuracy, consistency and compliance based on Moda Health policies and procedures, state, federal and CMS (Medicare)/Medicaid regulations. Identifies problems and researches alternative solutions. Works with other team members to maintain the workflow to meet productivity and compliance standards. Completes other duties and special projects as assigned by the HCS Supervisor and/or the HCS Manager. Maintains an established productivity based on the complexity and demands of a heavy workload, complex services agreements, provider contracts and complex benefit packages. Responsible for utilizing all applicable policies, procedures and materials used in determining the proper review of claims, review, and processing of prior authorization requests for services. Enter data into appropriate system Facets UM or CT Dynamo must be able to accurately determine member eligibility and provider participation within a network. Maintain accurate patient note entry when not approving a request, when awaiting additional information or when routing the referral or preauthorization request. Perform other tasks as assigned. Working Conditions & Contact with Others Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 37.5 hours per week, including evenings and occasional weekends, to meet business need. Internally with own department and Customer Service. Externally with Moda members, PBM vendor, providers, provider offices. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations please direct your questions to Kristy Nehler and Danielle Baker via our ***************************** email.

Let's do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together. Position Summary The Dental Fraud and Abuse Investigator is responsible for providing accurate and appropriate documentation, research and resolution of written correspondence received from providers and potential Fraud and Abuse investigations under minimal supervision and ensure all resolution letters are in accordance with Delta Dental standards. This is a FT WFH position. Pay Range $25.08 - $28.21 hourly (depending on experience) **Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. ************************** GK=27768546&refresh=true Benefits: Medical, Dental, Vision, Pharmacy, Life, & Disability 401K- Matching FSA Employee Assistance Program PTO and Company Paid Holidays Required Skills, Experience & Education: Bachelor's degree or equivalent work experience. 2 years of experience as a Claim Support or Customer Service Representative preferred Typing proficiency of 25 wpm & 10-key proficiency of 105 kspm net on a computer keypad Demonstrated knowledge of dental terminology, multiple benefit plans, and products. Ability to meet correspondence review timelines. Knowledge and understanding of correspondence and fraud and abuse procedures. Detail oriented and proven initiative, analytical, and problem-solving abilities. Highly effective organizational skills with the ability to prioritize and meet deadlines. Strong reading, verbal, written and interpersonal communication skills. Must be able to work independently, as well as part of a team, dealings with all levels of staff, members, providers, and external customers in a professional manner. Ability to work under pressure and exhibit flexibility in changing priorities. Working knowledge of dental terminology. Proficiency in Moda Health operating systems. Demonstrated proficiency in computer applications such as Word, and Excel. Ability to maintain confidentiality and project a professional business image. Ability to communicate positively, patiently, and courteously. Ability to come into work on time and daily. Primary Functions: Coordinates interpreting contracts/handbooks, and policies and understands overall dental health plan processes. Utilizes guidelines to conduct extensive research and analyzes correspondence and/or fraud and abuse cases pertinent to dental claims to make decisions. Reviews clinical records for completeness and determines if the case is related to an administrative policy or clinical decision. Creates packet for clinical decisions for dental consultants/clinicians to review. Will review all administrative policies to respond directly to those. Independently assesses, investigates, and resolves difficult issues by utilizing company and industry knowledge of operational areas and all established policies and procedures. Organizes the volume of work and maintains a constant caseload. Monitors day to day compliance of cases to ensure that the various state and federal mandated response time frames are met. Communicates in writing or telephone call with members, providers, or attorneys regarding claims and policies about Moda Dental Health benefit plans. Requests additional information such as chart notes or other clinical from providers as needed. Accurately enters all correspondence and fraud and abuse cases into the appropriate tacking systems as needed for various reporting and auditing requirements. Consults with management staff on problem cases and interfaces with interdepartmental personnel in resolving provider correspondence and fraud and abuse questions. Responsible for ensuring the correspondence for fraud and abuse cases are completely resolved which may include reaching out to other departments. Prepares all cases upon receipt of the correspondence or fraud and abuse case. Researches and responds to all dental provider correspondence. Performs all primary functions of a dental claims support processor level II which would include adjusting any claims based on outcome of various types of reviews. Other duties as assigned. Working Conditions & Contact with Others Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need. Internally with dental claims, customer service, membership accounting, and other internal departments. Externally with providers, members, dental consultants, and others. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations please direct your questions to Kristy Nehler or Danielle Baker via our ***************************** email.