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

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

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

The Health Care Coordinator (HCC) acts an entry point to CareOregon's Regional Care Teams, as well as provides care coordination. This position provides intake functions, physical and behavioral health plan navigation, and care coordination including assessing member needs, developing individualized care plans, coordinating with providers and with members. A focus of this

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

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

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

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

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

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

Promote lifelong learning opportunities through degree programs using tuition assistance (TA), testing opportunities, credentialing assistance (CA), Reserve Component Student Loan Repayment Program (RC SLRP) and any GI Bill Program available to Soldiers and family members. Responsible for providing support services to assist Government professionals in the delivery of adu

Who We Are Boston Consulting Group partners with leaders in business and society to tackle their most important challenges and capture their greatest opportunities. BCG was the pioneer in business strategy when it was founded in 1963. Today, we help clients with total transformation inspiring complex change, enabling organizations to grow, building competitive advantage,

Who We Are Boston Consulting Group partners with leaders in business and society to tackle their most important challenges and capture their greatest opportunities. BCG was the pioneer in business strategy when it was founded in 1963. Today, we work closely with clients to embrace a transformational approach aimed at benefiting all stakeholders empowering organizations to

WHAT YOU'LL DO As a Senior Knowledge Analyst (SKA) In a Client Focused role within BCG's Technology, Media and Telecom (TMT) Practice Area, you will work in a growing global team, delivering value to clients via individual expertise and/or institutionalized knowledge assets (products, tools, data, workshops, frameworks, surveys, domain specific data and related expertise,

Who We Are Boston Consulting Group partners with leaders in business and society to tackle their most important challenges and capture their greatest opportunities. BCG was the pioneer in business strategy when it was founded in 1963. Today, we help clients with total transformation inspiring complex change, enabling organizations to grow, building competitive advantage,