Director, Provider Data & Credentialing Leadership

CareOregon, Inc.; Oregon; Hybrid; USD 155,000 - 190,000; Full time

Benefits offered by this job

Total Rewards Program

Bonus opportunity

Job summary

CareOregon, Inc. seeks a Director of Provider Data Management to lead enterprise provider data management and credentialing across Medicaid and Medicare lines. This role oversees strategy, operations, budgets, and staff to ensure compliant, accurate provider data and seamless network operations.

The position requires onsite presence in downtown Portland 3 days per week, with candidates in the Portland Metro area encouraged to apply. A strong Total Rewards Program and bonus target are offered.

Qualifications

• Minimum 10 years’ experience in health plan operations, provider network engagement and/or hospital or medical staff credentialing.

Responsibilities

• Provide strategic leadership for provider data management and credentialing.
• Develop and oversee initiatives to ensure network development and provider data quality.
• Ensure practitioners are credentialed per plan policies and maintain data accuracy.
• Optimize provider data systems for accurate claims and directory presentation.
• Use business intelligence to monitor data accuracy and forecast needs.
• Ensure compliance with federal, state, and contractual requirements.

Skills

Strategic leadership

People management

Provider data management

Credentialing oversight

Data analytics

Regulatory compliance

Budgeting

Job description

CareOregon, Inc. seeks a Director of Provider Data Management to lead enterprise provider data management and credentialing across Medicaid and Medicare lines. This role oversees strategy, operations, budgets, and staff to ensure compliant, accurate provider data and seamless network operations.

The position requires onsite presence in downtown Portland 3 days per week, with candidates in the Portland Metro area encouraged to apply. A strong Total Rewards Program and bonus target are offered.