Rate Development Manager - CareOregon
Portland, OR
About the Job
Job Title
Rate Development Manager
Exemption Status
Exempt
Management Level
Manager
Direct Reports
Rate Development Analysts
Manager Title
Director, Finance - Lines of Business
Department
Finance
Requisition
24636
Pay & Benefits
Estimated hiring range $121,770 - $148,830 / year, 5% bonus target, full benefits. www.careoregon.org/about-us/careers/benefits
Posting Notes
This is a hybrid position that will require you to work out of our Downtown Portland, OR office.
Job Summary
This position is responsible for leading the rate development process for CareOregon and its Coordinated Care Organizations (CCOs) and serves as a liaison between CareOregon and the Oregon Health Authority (OHA). This includes ongoing education and historical perspectives of the rate cycles over time as well as coordinating feedback from other CO departments with OHA.
Essential Responsibilities
Technical Leadership
+ Rates
+ Lead the rate development process for CareOregon and its CCOs.
+ Work with the CEOs and financial personnel of each CCO, members of the Metro integrated community network, line of business leaders, internal behavioral health, dental and NEMT leaders, and members of related external organizations to communicate rate updates and their implications.
+ Serve as a financial representative where needed.
+ Work with outside actuaries and the State’s Office of Actuarial and Financial Analytics (OAFA) team to promote fair rates.
+ Serve as one of the primary financial liaisons between CareOregon, its CCOs, OAFA and the State’s Office of Forecasting, Research and Analysis (OFRA).
+ Coordinate responses to OHA on behalf of CareOregon on finance and contract related matters.
+ Work closely with members of the Finance Team and in-house actuarial staff to ensure rate updates are communicated timely.
+ Provide budget rate tables and work closely with the Finance Team to ensure accurate revenue budgets for each line of business and benefit type.
+ Provide rates information to the Information Services department for 820 programming and ensure accuracy of the output of the 820 process.
+ Prepare reports, updates and presentations as requested.
Employee Supervision
+ Supervise (or manage) team and recommend team direction and goals in alignment with the organizational mission, vision, and values.
+ Identify work and staffing needs to meet work expectations; recruit and hire, using an equity, diversity, and inclusion lens.
+ Plan, organize, schedule, and monitor work; ensure employees have information and resources to meet job expectations.
+ Lead the development, communication, and oversight of team and individual goals; ensure goals, expectations, and standards are clearly understood by staff.
+ Train, supervise, motivate, and coach employees; provide support toward employee development.
+ Incorporate guidance from CareOregon equity tools into people leadership, planning, operations, evaluation, and decision making.
+ Ensure team adheres to department and organizational standards, policies, and procedures.
+ Evaluate employee performance and provide regular feedback to support success; recognize strong performance and address performance gaps and accountability (corrective action).
+ Perform supervisory tasks in collaboration with Human Resources as needed.
Organizational Responsibilities
+ Perform work in alignment with the organization’s mission, vision and values.
+ Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
+ Strive to meet annual business goals in support of the organization’s strategic goals.
+ Adhere to the organization’s policies, procedures and other relevant compliance needs.
+ Perform other duties as needed.
Experience and/or Education
Required
+ Minimum 6 years’ financial analysis and/or accounting experience, including minimum 3 years’ experience in rate development or related experience
Preferred
+ Minimum 2 years’ experience in a supervisory position or minimum 1 year experience in a supervisory position with completion of CareOregon’s Aspiring Leaders Program
+ Rate development experience in Commercial Healthcare, Medicare and Medicaid
Knowledge, Skills and Abilities Required
Knowledge
+ Strong understanding of rate development methodologies and practices
+ Understanding of medical costs and trends
+ Familiar with the Medicaid and Medicare business
+ Familiar with healthcare rate setting processes
Skills and Abilities
+ Advanced spreadsheet and data analysis skills
+ Intermediate word processing skills
+ Excellent written and verbal communication skills
+ Ability to focus on and comprehend information, learn new skills and abilities, assess a situation and seek or determine appropriate resolution, accept managerial direction and feedback, and tolerate and manage
+ Ability to effectively collaborate with multiple stakeholders
+ Ability to manage multiple tasks
+ Ability to problem solve, analyze and provide written documentation of analysis
+ Ability to communicate project status and issues to manager timely
+ Ability to manage, develop, and coach staff
+ Ability to effectively lead and facilitate meetings
+ Ability to work effectively with diverse individuals and groups
+ Ability to learn, focus, understand, and evaluate information and determine appropriate actions
+ Ability to accept direction and feedback, as well as tolerate and manage stress
+ Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
+ Ability to hear and speak clearly for at least 3-6 hours/day
Working Conditions
Work Enviornment(s): ☒ Indoor/Office ☐ Communit y ☐ Facilities/Security ☐ Outdoor Exposure
Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person
Hazards: May include, but not limited to, physical and ergonomic hazards.
Equipment: General office equipment
Travel: 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.
Work Location : Work from home
#LI-HYBRID
Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.
Veterans are strongly encouraged to apply.
We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.
Visa sponsorship is not available at this time.
Source : CareOregon
