Prior Authorization Review Coordinators

Do you have an interest in helping Oregonians in need by assisting healthcare providers? Do you have at least three years of experience dealing with the public in-person or by phone providing information about services and programs; explaining rules, programs, and procedures; and/or providing assistance, explaining requirements, and gaining compliance?  We look forward to hearing from you! 

Work Location: Salem/Marion; hybrid position

What you will do! 

The Prior Authorization Review Coordinator (PARC) is responsible for receiving prior authorization (PA) requests for services covered by the Oregon Health Plan and initiating the steps required to complete the processing, review and determination of the PA requests.  This position utilizes Oregon Administrative Rules, member information and benefit package information to interpret applicable rules, regulation, decisions, policies and procedures to ensure that complete and accurate PA information has been received from the requestor and assisting the requester with compliance of program requirements.

This position also supports Medicaid service providers by operating a provider hotline during normal business hours, and by managing a variety of tasks related to prior authorization and unit functions. 

OHA values service excellence, leadership, integrity, health equity and partnership and has a strategic goal to end all health inequities by 2030.

What's in it for you?

• We offer exceptional medical, vision and dental benefits packages for you and your qualified family members, with very low monthly out-of-pocket costs. Try this free virtual benefits counselor by clicking here: https://www.oregon.gov/oha/pebb/pages/alex.aspx
• Paid Leave Days:
  • 11 paid holidays each year
  • 3 additional paid "Personal Business Days" each year
  • 8 hours of paid sick leave accumulated every month
  • Progressive vacation leave accrual with increases every 5 years
• Pension and retirement programs
• Optional benefits include short-term disability, long-term disability, deferred compensation savings program, and flexible spending accounts for health care and childcare expenses.
• Click here to learn more about State of Oregon benefits.

WHAT WE ARE LOOKING FOR:

Minimum Qualifications

Three years of experience performing public contact and/or customer service duties comparable to the work of a Public Service Representative.

At least two years of this experience must include dealing with the public in-person or by phone providing information about services and programs; explaining rules, programs, and procedures; and/or providing assistance, explaining requirements, and gaining compliance.

Desired Attributes

• Experience supporting the implementation of policies, projects and programs at the community, state, and/or national level that advance health equity, address systemic health disparities, and elevate the voice of community and those with lived experience.
• Experience within the context of healthcare claims processing.
• Knowledge of federal requirements, state rules and program requirements for the Oregon Medicaid Program
• Demonstrates skills in the following areas:  
  • Constructive and Collaborative Working Relationships 
  • Critical Decision-making and Problem-solving
  • Customer Service and Person-centered Engagement
  • Data Synthesis, Analysis and Reporting
  • Project Planning and Prioritization
  • Workload Planning & Prioritization
  • Strong Oral and Written Communication, including preparation of reports 
  • Technical and Computer Skills
  • Training and Technical Assistance

How to apply:

Complete the online application at oregonjobs.org using job number REQ-157052

Application Deadline: 05/26/2024

Salary Range: $3948 - $5483

https://oregon.wd5.myworkdayjobs.com/SOR_External_Career_Site/job/Salem--OHA--Summer-Street/Prior-Authorization-Review-Coordinators---two--2--positions--Public-Service-Representative-4-_REQ-157052