Manager, Contract & Credentialing

Roseburg, OR

Full Time

Network & Contracting

Manager/Supervisor

MANAGER, CONTRACT & CREDENTIALING

HYBRID, must be able to travel to 3031 NE STEPHENS ST. ROSEBURG, OR 97470

EMPLOYMENT TYPE: Full-Time, Exempt

About Umpqua Health

At Umpqua Health, we’re more than a healthcare organization—we’re a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon. We provide integrated, whole-person care through primary care, specialty care, behavioral health services, and care coordination. Our collaborative approach ensures members receive high-quality, personalized care while supporting a stronger, healthier community.

POSITION PURPOSE
The Contract and Credentialing Manager is responsible for supporting service area agreements with highly visible providers, including integrated delivery systems, hospitals, and physician groups. This role ensures contracts deliver high-quality, cost-effective, and marketable provider networks that meet organizational standards. The position also manages corporate and network contracts to support strategic goals and oversight of all delegated credentialing.

ESSENTIAL JOB RESPONSIBILITIES

Manage high-priority physician group, facility, corporate, and network contracts in alignment with PADU (Preferred, Acceptable, Discouraged, Unacceptable) guidelines.
Develop, negotiate, execute, and maintain provider contracts within contract management systems.
Recruit and negotiate with providers to improve network access, reduce grievances, and support cost control strategies, including Medical Loss Ratio (MLR) optimization.
Maintain effective relationships with key providers and advise Contract Coordinators and Specialists on provider and ancillary contract negotiations.
Evaluate network performance and implement strategies to ensure compliance with network adequacy standards.
Ensure contract language meets organizational and regulatory requirements in collaboration with legal counsel.
Support development of fee schedules and reimbursement models in partnership with Corporate Network Management and legal.
Educate internal stakeholders on provider contracting processes.
Participate in strategic initiatives and organizational committees.
Ensure timely submission of all required contracting related deliverables to the Oregon Health Authority.
Collaborate with internal departments to gather data and documentation for OHA reporting.
Oversee and coordinate Network Performance Subcommittee.
Oversee delegated credentialing entities for compliance.
Provide leadership and supervision to the Contracting and Network team.
Perform other duties as assigned

CHALLENGES

Working with a variety of personalities, maintaining a consistent and fair communication style.
Satisfying the needs of a fast-paced and challenging company.

MINIMUM QUALIFICATIONS

Bachelor’s degree in a healthcare-related field or equivalent combination of education and experience.
5–7 years of experience in Medicaid contracting and healthcare network management.
Knowledge of Medicaid, Medicare and Commercial healthcare operations, compliance, and credentialing processes.
Strong organizational, analytical, and problem-solving skills.
Effective communication and interpersonal skills, with the ability to collaborate across teams.
Ability to manage competing priorities and meet deadlines in a fast-paced environment.
Accountability: Takes ownership of responsibilities and outcomes.
Integrity: Maintains confidentiality and adheres to ethical standards.
Innovation: Identifies opportunities for improvement and implementing solutions.
Collaboration: Works effectively with diverse teams and stakeholders.

PREFERRED QUALIFICATIONS

Bilingual translation or translation capabilities a plus

SCHEDULE
Monday through Friday - 8:00am - 5:00pm; standard business hours with flexibility to meet service timelines.

SALARY
Wage Band 21: $106,000- $118,000

BENEFITS

Salary is dependent on skills, experience, and education
Generous benefits package including vacation PTO, sick leave, federal holidays, and birthday leave
Medical, dental, and vision insurance
401(k) with company match (fully vested immediately)
Company-sponsored life insurance and additional benefits
Fitness reimbursement program
Tuition reimbursement and more

Why Umpqua Health?

We are committed to advancing health equity by collaborating across communities, addressing systemic barriers, and ensuring fair access to care and resources. At Umpqua Health, every team member plays a vital role in making a meaningful impact, empowering healthier lives and strengthening the communities we serve.

Inclusive Culture
We foster a respectful, inclusive environment where employees feel valued, supported, and empowered.

Growth & Development
We support ongoing learning through mentorship, clear career pathways, and professional development opportunities.

Work/Life Balance
We promote flexibility and well-being so employees can thrive both professionally and personally.

Equal Opportunity

Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.

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