Provider Partnership Strategist

PacificSource•Salem, OR

17h

About The Position

The Provider Partnership Strategist provides strategic oversight for designated complex provider partnerships, supporting operational efficiency, cost management, quality, and improved health outcomes. The role collaborates with PacificSource stakeholders and external provider representatives to plan, implement, and support Joint Operating Committee (JOC) initiatives, and serves as a primary point of contact for JOC facilitation. It builds and strengthens provider relationships through education, reporting, proactive identification of improvement opportunities, and assistance with region-specific strategies and coaching. The position manages initiatives and projects across lines of business; provides training and support to provider organizations; coordinates process improvements and workflows; tracks project progress and JOC schedules; and helps resolve provider issues involving areas such as claims, contracts, operations, quality, risk adjustment, financial arrangements, and reporting. It supports data review and presentation, develops collaborative roadmaps, and works with internal and external stakeholders to advance provider and company goals. The role requires at least five years of relevant experience in health insurance, a provider organization, or a related partnership-building field. A bachelor’s degree or equivalent work experience is desired. The position is based in a general office environment with ergonomically configured equipment and requires approximately 25–50% travel. The listed base salary range is $65,296.83–$111,004.62.

Requirements

At least 5 years of experience in the health insurance industry, a provider organization, or an associated field related to partnership building.
Thorough understanding of services and processes, administrative procedures, government compliance, and the health insurance industry.
Demonstrated experience in several of the following: managing complex projects, developing and executing strategy, understanding provider contracts and their impacts, process improvement, and data analysis and reporting.
Knowledge of coding methodologies.
General understanding of financial arrangements and quality programs across health care products.
Excellent written and verbal communication, public relations, and public speaking skills; ability to explain plans and administration to groups with varying educational backgrounds and familiarity with benefits.
Ability to communicate effectively with diverse individuals and internal departments, and provide prompt, professional, courteous service.
Ability to work in a fast-paced environment while managing shifting priorities and multiple tasks.
Strong work leadership skills, including taking action without specific direction; ability to work autonomously and independently.
High integrity and trustworthiness when handling confidential material.
Ability to remain resilient, flexible, and focused in a changing environment; willingness to learn, anticipate problems, and develop contingency plans.
Proficiency in Microsoft Word, Excel, PowerPoint, and Outlook.
Ability to read and comprehend written and spoken English and communicate clearly and effectively.
Ability to meet the position’s physical requirements, including stooping and bending, extended sitting or standing, repetitive typing, sorting and filing, and light lifting and carrying.

Nice To Haves

A BA or BS in business, health care administration, finance, or equivalent work experience.
Experience in project management.
Demonstrated ability to facilitate, implement, and measure improvement projects.
Thorough understanding of products, contracts, administrative procedures, and the health insurance industry’s legal and mandatory guidelines.

Responsibilities

Manage initiatives, activities, and projects arising from provider partnership and PacificSource opportunities across all lines of business.
Provide ongoing training, coaching, and high-touch support to provider systems and staff to develop and implement process-improvement activities.
Collaborate across departments to develop and deploy aligned initiatives, improve workflows, streamline processes, and support provider satisfaction and member outcomes.
Track project progress and communicate with JOC participants and stakeholders; develop and manage JOC schedules, timelines, activities, and milestones.
Support providers through contracting audits and liaison work with internal departments on claims processing, facilities, and provider and group setup.
Educate providers on PacificSource products, administrative procedures, legislative requirements, and compliance requirements.
Work with Provider Network and departmental leaders and JOC work-stream leaders to advance initiatives.
Present and review data with internal stakeholders and business owners, and deliver provider reporting packages.
Identify opportunities and trends, tools, and proposed actions to support incentive, quality, and operational goals.
Work with consultants and hospital departments to develop strategic direction based on existing processes and opportunities.
Create and help execute collaborative roadmaps to accomplish established goals.
Prepare meeting materials and presentations with applicable colleagues and participate in group operational meetings.
Receive, analyze, and respond to provider issues, ensure timely follow-up, identify potential trends, and seek resolution.
Serve as a provider contact and problem solver for claims, operations, encounters, quality, risk, billing, health services notifications, financial and capitation matters, contractual details, and data or reporting needs.
Understand contracting methodologies and terms across lines of business and develop positive working relationships with PacificSource departments to resolve provider issues.
Develop knowledge of Facets setup, Facets Business Support, and other supporting systems; maintain understanding of system setup and reporting requirements and limitations.
Exercise independent judgment and communicate effectively between internal and external team members.
Meet department and company performance and attendance expectations; comply with privacy policy and HIPAA requirements for confidentiality and security of protected health information.
Participate in provider-specific and public presentations, assist with special projects, and perform other duties as assigned.