Job Listing ID:

4548680

Job Title:

Benefits Administration Manager

Application Deadline:

Open Until Filled

Job Location:

Roseburg

Date Posted:

08/14/2026

Hours Worked Per Week:

40

Shift:

Day Shift

Duration of Job:

Full Time, more than 6 months SR You may contact this employer directly. (Obtain the contact information to print or add to your jobs.) Obtain Contact Information Job Summary

Benefits Administration Manager Minimum Salary:

DOE POSITION SUMMARY

This position is responsible for overseeing the day-to-day administration and operations for Cow Creek Band of Umpqua Tribe of Indians health plan, Nesika Health that is self-fund and self-administered for employees and Tribal Members. This position ensures that member eligibility, enrollment, claims processing, benefit determinations, appeals, customer service, vendor coordination, financial controls, and regulatory requirements are managed accurately, efficiently, and consistently with the governing plan documents. This position works closely with Director of Benefits to assist with Risk Management, stop loss tracking and reporting, and Purchase and Referred Care (PRC) Tribal programs. This position provides leadership, guidance and training to administration staff, monitors operational performance and is responsible for identifying opportunities to strengthen internal controls, improve member service, manage plan costs, and ensure the continued integrity of the health plan.

QUALIFICATIONS

' Associates Degree or greater in related field. ' Five years experience in employee benefits, health plan administration, healthcare claims, insurance operations, or related field. ' Two years of supervisory, lead, or management experience. ' Health and Life State License (if not current, may be completed within 6 months of hire). ' Knowledge of provider billing, medical coding, utilization management, coordination of benefits, subrogation and third-party liability. ' Proficiency with claims administration systems, eligibility systems, Office 365 applications, and reporting tools. ' Strong analytical and problem-solving skills, including the ability to identify discrepancies, trends, operational risks, and cost drivers. ' Knowledge of medical and prescription benefit terminology, claims processing practices and eligibility administration. ' Current and valid Oregon Driver's License with the ability to qualify for the Cow Creek Government Office Drivers Program.

ESSENTIAL

DUTIES and

RESPONSIBILITIES

•

SEE URL LISTING FOR FULL DETAILS

•' Manage the daily operations of self-funded, self-administered health plan and Tribal programs and provide support to Director of Benefits Administration and Risk Manager. ' Review complex or unusual benefit questions and offer recommendations regarding appropriate plan administration. ' Interpret plan provisions and provide guidance to staff, members, providers, and organizational leadership regarding coverage, exclusions, limitations, and administrative requirements. ' Promote responsive, respectful, and accurate service to members, dependents, providers, and organizational stakeholders. ' Oversee administration of appeals, grievances, benefit inquires and ensure adverse benefit determinations and appeal responses are accurate, timely, clearly written, and consistent with plan requirements. ' Establish and maintain quality assurance processes, including claim audits, accuracy reviews, and corrective action procedures. Compensation and Benefits Managers Access our Statewide and Regional occupation report for more information about wages, employment outlooks, skills, training programs, related occupations, and more. Compensation Depending on Experience, Depending on Qualifications

Benefits Offered:

Medical, Dental, Vision, Vacation, Sick Leave, Life Insurance, Short-Term Disability, Long-Term Disability, Retirement Job Requirements

Experience Required:

At least 5 years

Education Required:

Associates

Minimum Age:

N/A

Employer Will Perform:

Background Check