{"id":1505846,"url":"https://alion.io/job/careoregon-director-provider-data-management","title":"Director, Provider Data Management","company":{"id":1968739,"name":"CareOregon","domain":"careoregon.org","url":"https://alion.io/company/careoregon","size_band":"51-200","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"A","score":97,"open_postings":3,"ghost_share":0,"stale_share":0.333,"repost_share":0,"time_to_fill_p50_days":9,"computed_at":"2026-10-15T05:46:00Z"}},"role":"Leadership","role_family":"Leadership","seniority":"head","employment_type":"full_time","work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Portland, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":{"min_usd":128000,"max_usd":240000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":2407},"experience_years_min":10,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Supervision","optional":false}],"status":"live","first_seen_at":"2026-07-08T00:00:00Z","employer_posted_date":"2026-07-08","last_verified_at":"2026-10-14T21:14:30Z","board_verified":true,"closed_at":null,"days_open":99,"trust":{"level":"stale","repost_count":0,"flags":["stale"],"days_open":99},"description":"Director, Provider Data Management---------------------------------------------------------------\nThis position is responsible for enterprise leadership and strategic oversight of CareOregon’s provider network data management, including provider data management and credentialing. Primary duties include strategic and operational leadership and planning, as well as resource, relationship, and people management. The Director ensures cohesive operations support, timely and accurate provider data configuration, credentialing oversight, and overall operational excellence across Medicaid and Medicare lines of business. This position is also accountable for ensuring all plan operations are compliant with OHA, CMS, and NCQA standards as applicable.This position is required to be in the downtown Portland office 3x/week, We are looking for candidates in the Portland Metro area.\nEstimated Hiring Range:\n$155,430.00 - $189,970.00Bonus Target:\nBonus - SIP Target, 10% AnnualCurrent CareOregon Employees: Please use the internal Workday site to submit an application for this job.\n---------------------------------------------------------------\nEssential Responsibilities\nTechnical/Operational Leadership\nProvide strategic leadership for provider data management, including credentialing, and provider data.\nDevelop and oversee execution of proactive strategic initiatives to ensure appropriate network development and wholistic provider data management.\nEnsure network practitioners are credentialed per plan policies.\nEnsure provider data systems are optimized to enable strategic network management, including accurate and timely claims processing and directory presentation.\nEffectively use business intelligence and data analytics to monitor network data accuracy, forecast system changes and overall plan data needs.\nEnsure compliance with federal, state, and contractual requirements.\nIdentify and implement process improvement activities to improve department productivity.\nEnsure documented policies and procedures are established and maintained to ensure accurate, efficient, and compliant operations.\nRemain current with healthcare industry trends, best practices, and approaches to drive efficient and compliant network operations.\nFinancial/Resource Management\nDevelop budgets in alignment with strategic planning.\nEnsure teams have sufficient resources to perform their work.\nEnsure budgets are monitored and managed effectively across areas of oversight.\nApprove resource allocations within budget, including people, finances, and timelines.\nRelationship Management\nEnsure strategic messages are regularly and effectively relayed to management team and staff; promote transparency.\nCollaborate with leaders across the organization in identifying integrated improvement strategies and ensuring meaningful integration.\nEmployee Supervision\nDirect team(s) and establish team direction and goals in alignment with the organizational mission, vision, and values.\nIdentify work and staffing models; recruit, hire, and oversee a team to meet work needs, using an equity, diversity, and inclusion lens.\nIdentify department priorities; ensure employees have information and resources to meet job expectations.\nLead the development, communication, and oversight of team and individual goals; ensure goals, expectations, and standards are clearly understood by staff.\nManage, coach, motivate, and guide employees; promote employee development.\nEvaluate employee performance and provide regular feedback to support success; recognize strong performance and address performance gaps and accountability (corrective action).\nPerform supervisory tasks in collaboration with Human Resources as needed.\nOrganizational Responsibilities\nPerform work in alignment with the organization’s mission, vision and values.\nSupport the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.\nStrive to meet annual business goals in support of the organization’s strategic goals.\nAdhere to the organization’s policies, procedures and other relevant compliance needs.\nPerform other duties as needed.\nOrganizational Responsibilities\nPerform work in alignment with the organization’s mission, vision and values.\nSupport the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.\nStrive to meet annual business goals in support of the organization’s strategic goals.\nAdhere to the organization’s policies, procedures and other relevant compliance needs.\nPerform other duties as needed.\nExperience and/or Education\nRequired\nMinimum 10 years’ experience in health plan operations, provider network engagement and/or hospital or medical staff credentialing.\nPreferred\nMinimum 4 years’ supervisory experience\nManagement experience in a managed care organization or provider practice setting\nProvider relations experience\nKnowledge, Skills and Abilities Required\nKnowledge\nStrong understanding of Medicaid in a managed care environment\nUnderstanding of claims, provider directories and provider data\nUnderstanding of how to manage a production-oriented workforce\nUnderstanding of credentialing policies & practices\nUnderstanding of network regulatory reporting, including DSN and HSD tables\nKnowledge of federal Medicare regulations and state Medicaid rules (OARs)\nSkills and Abilities\nSkilled in strategic thinking and executing strategy effectively; ability to think at an enterprise level\nLeadership effectiveness and ability to design and implement constructive change\nStrong people management skills, including the ability to coach and motivate teams\nExcellent critical thinking, analytical and problem-solving skills; ability to effectively analyze program goals and objectives to determine successes and opportunities for improvement\nAbility to effectively analyze program goals and objectives to determine successes and opportunities for improvement\nAbility to effectively convey business unit goals and plans ensuring integration into strategic plans and initiatives\nHighly skilled in resource management\nAbility to communicate effectively, both verbally and in writing, including strong presentation and change management skills\nAbility to influence and build consensus\nAbility to work in an environment with matrix reporting, diverse individuals and groups\nAbility to work effectively with diverse individuals and groups\nAbility to learn, focus, understand, and evaluate information and determine appropriate actions\nAbility to accept direction and feedback, as well as tolerate and manage stress\nWorking Conditions\nWork Environment(s): Indoor/Office Community Facilities/Security Outdoor Exposure\nMember/Patient Facing: No Telephonic In Person\nHazards: May include, but not limited to, physical and ergonomic hazards.\nEquipment: General office equipment\nTravel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.\nWork Location: Office - 3 days/week\nWe offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregonoffers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information.\nWe are an equal opportunity employer\nCareOregonis an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.","description_format":"text","description_chars":9122,"description_truncated":false,"requirements":{"experience_years_min":10,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":["Equity","Retirement plans"],"hiring_locations":[],"hiring_excludes":[],"relocation_offered":false,"industries":["Professional Services","Nonprofits & Foundations","Health Insurance & Benefits"],"lifecycle":[{"event":"open","at":"2026-09-30T05:40:06Z"}],"visa":[{"country":"US","licensed_sponsor":true,"evidence":"H-1B filings in 12 months: 7","filings_12m":7,"filings_prev_12m":3,"green_card_filings_12m":0,"median_offered_wage_usd":142500,"route":null,"cap_exempt":false,"checked_at":"2026-10-03T21:08:04+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)","US Department of Labor: PERM disclosure data (green cards)"],"filings_for_role_12m":0}],"liveness":{"score":9,"band":"cold","label":"Long shot","p_open":1,"p_active":0.332,"p_room":0.28,"age_days":99,"expected_fill_days":9,"reasons":["conf:8","velocity","win:tail","crowd:"],"computed_at":"2026-10-15T05:46:00Z"},"pay":null,"html_url":"https://alion.io/job/careoregon-director-provider-data-management","json_url":"https://alion.io/job/careoregon-director-provider-data-management.json","meta":{"generated_at":"2026-10-15T09:00:08Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":13731,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-16T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":1968739},"rest":"https://alion.io/mcp/rest/get_company?id=1968739"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fcareoregon-director-provider-data-management"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fcareoregon-director-provider-data-management"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fcareoregon-director-provider-data-management"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/careoregon-director-provider-data-management\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fcareoregon-director-provider-data-management"}]}