Providence Risk Services Consultant in Beaverton, Oregon
Providence St. Joseph Health is calling a Risk Services Consultant to our location in Beaverton, OR.
We are seeking a Risk Services Consultant to be responsible for assisting Director, Risk Services with various risk services for Providence Health Plan and its affiliated organizations (Providence Plan Partners, Providence Health Assurance, Ayin Health Solutions, PH Tech). The programmatic responsibilities of the position include consultation, execution, and organization of regulatory licensing, service marks, administrative service agreements, legal/regulatory consultation regarding new service arrangements, Administrative Services Only/Third Party Administrator compliance, stand-alone pharmacy services regulation, and legal structure strategy and maintenance. The position oversees relevant working relationships with state and federal regulatory bodies and is accountable for developing, managing and communicating internal subject matter expertise regarding regulatory and contractual requirements as well as providing regulatory business expertise.
In this position you will have the following responsibilities:
Ensure the health plan obtains and maintains appropriate regulatory licensing necessary for all lines of business in all jurisdictions.
Legal structure strategy consulting and maintenance.
Maintain programs, policies and practices to ensure compliance with respect to Administrative Services Only, Third Party Administrator, and Pharmacy Services lines of business.
Provide risk and regulatory consultation regarding managed services arrangements and emerging lines of business.
Draft and assist in negotiation of service agreements for all lines of business.
Maintain processes for the management of service marks.
Provide appropriate assistance in furtherance of development and maintenance of corporate structure of the health plan family of companies.
Maintain inter company agreements.
Maintain effective relationships with regulatory bodies that have oversight authority applicable to scope of responsibilities.
Required qualifications for this position include:
Bachelor's Degree in Health Care Administration, Business Administration, Political Science or related field or a professional credential.
5 years work experience in the areas of regulatory compliance, contracting, legal and/or government relations, including preparation, review, administration, maintenance, and monitoring of contracts and other legal documents.
Preferred qualifications for this position include:
- 2 years prior experience with health plan regulatory compliance matters.
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
For information on our comprehensive range of benefits, visit:
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Compliance
Req ID: 264678