Operations Manager in Bend, OR, Oregon at Central Oregon Independent Practice Association CO

The Operations Manager is responsible for overseeing key operational functions, including Credentialing, Provider Enrollment and Billing. This role focuses on optimizing the day-to-day operations of the Central Oregon Independent Practice Association (COIPA). It supports organizational effectiveness by managing operational processes, coordinating cross-functional activities, ensuring compliance with healthcare and contractual requirements, and advancing strategic initiatives that enhance provider and member services.

The Operations Manager works closely with leadership, internal teams, providers, and external partners to ensure efficient operations aligned with COIPA’s mission and organizational goals. This position also provides direct oversight of the credentialing and billing teams, ensuring operational efficiency, regulatory compliance, and alignment with organizational standards and payer requirements.

• Manage and provide leadership to the billing team and credentialing staff, including workflow oversight, training, performance management, and process improvement.
• Assist leadership with strategic planning, organizational initiatives, and process improvement efforts.
• Oversee credentialing and recredentialing processes to ensure compliance with payer, regulatory, and organizational requirements. Monitor billing and credentialing operations to support accuracy, timeliness, and effective service delivery.
• Oversee payer enrollment activities, including initial enrollments, revalidations, and updates to support timely provider onboarding and network participation.
• Ensure the accuracy and integrity of provider data and payer enrollment records within the Credentialing Database and Enrollment Files.
• Monitor and address issues impacting billing claims processing, including identifying root causes of denials (credentialing, enrollment, provider data, and coding), staying current on insurance trends and allowables to support accurate reimbursement.
• Ensure compliance with organizational policies, HIPAA requirements, regulatory standards, contractual obligations, and payer requirements.
• Monitor operational metrics and identify opportunities to improve efficiency, service delivery, and member/provider satisfaction.
• Support onboarding and ongoing operational support for providers and staff.
• Collaborate with leadership on budgeting, resource allocation, vendor management, and operational planning.
• Prepare operational reports, analyze data, and present recommendations to leadership.
• Manage and maintain relationships with vendors, business partners, and contracted entities.
• Support a positive, collaborative, and service-oriented workplace culture.
• Participate in meetings, committees, and special projects as assigned.
• Knowledge of healthcare operations, including credentialing, provider enrollment, revenue cycle processes, billing issue resolution, managed care, provider networks, or IPA environments preferred.
• Strong understanding of regulatory and compliance requirements, including HIPAA, NCQA, CMS NCCI and payer guidelines.
• Strong organizational, analytical, and problem-solving skills.
• Excellent interpersonal, verbal, and written communication skills, with the ability to collaborate effectively with internal teams, providers, and external partners.
• Ability to manage multiple priorities, meet deadlines, and work independently in a fast-paced environment, deadline-driven environment.
• Proficiency with Microsoft Office Suite and healthcare-related systems/software (e.g., credentialing databases, payer portals, billing systems, EHRs).
• Strong attention to detail and commitment to accuracy.
• Ability to maintain confidentiality and exercise sound judgment.
• Demonstrated ability to support team development, foster collaboration, and contribute to a positive work environment.

Bachelor’s degree in Healthcare Administration, Business Administration, Operations Management, or related field preferred.

Minimum of 3–5 years of operations, healthcare administration, or management experience preferred.

This position follows a hybrid work model. Duties are performed both remotely and onsite at the COIPA office, with an expectation of being onsite 3 to 4 days per week, as determined by organizational needs and the employee’s role.

COIPA is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, and gender identity), national origin, age, disability, genetic information, marital status, veteran status, or any other status or characteristic protected by applicable federal, state, or local law.

NOTE: The statements herein are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.