Provider Relations Executive

Cambia Health Solutions • Portland, OR

6d • $82,000 - $89,500 • Hybrid

About The Position

Every day, Cambia’s dedicated team of Provider Relations Executives are living our mission to make health care easier and lives better. As a member of the Provider Experience team, our Provider Relations Executives oversees contract management, facilitating coordination between Cambia departments, network leadership, and providers to ensure seamless provider experiences, resolve issues, and build strong relationships – all in service of making our members’ health journeys easier. Do you have the ability to build and maintain strong relationships with providers and internal stakeholders? Do you have strong knowledge of healthcare industry trends, regulations, and best practices? Do you value the betterment of member care? Then this role may be the perfect fit.

Requirements

• Provider Relations Executive would have a Bachelors degree in Healthcare Administration or related field and a minimum of 5 years of experience in the healthcare industry with specific focus in provider relations, provider contracting, customer service, financial analysis: Provider/payer strategy development or implementation; Provider/payer contracting and reimbursement, preferably managed care; delivery system administration, or equivalent combination of education and experience.
• Valid driver’s license is required.
• Strong communication and facilitation skills to deliver challenging messages with diplomacy while maintaining strong relationships with provider partners.
• Self-directed with creative problem-solving skills to identify problems, develop solutions, and implement a chosen course of action to resolve issues and build consensus among diverse stakeholders.
• Professional presence, leadership, and knowledge of helping complex organizations affect change to improve their operations.
• Strong critical thinking, consulting, and influencing skills to present complex information simply and succinctly at all levels of the organization.
• Ability to effectively manage a variety of formal presentation settings, prioritize work, and meet timelines.
• Knowledge of healthcare systems, including provider coding, reimbursement, contract methodologies, products, and networks, as well as the inputs to the total cost of care for a population.
• Proficiency in using Microsoft Office tools, with the ability to travel extensively within the state and work in a high-pressure environment while managing conflict and ambiguity.

Responsibilities

• Develops and fosters collaborative partnerships with key providers and internal stakeholders, establishing credibility as a trusted advisor and resource to influence positive change.
• Documents provider information, tracks and reports performance metrics, and ensures providers have access to reports and tools to drive performance.
• Maintains knowledge of contract terms and performance targets, educates providers and internal stakeholders, and facilitates executive-level Joint Operating Committees to discuss performance and collaboration opportunities.
• Facilitates internal and external workgroups to review performance reports, identify opportunities, and drive action plans to improve clinical quality, cost containment, member experience, and provider experience.
• Coache providers to improve member health outcomes through engagement and enablement, monitors progress and communicates performance expectations to drive change.
• Identifies and leads new initiatives to assist providers in transitioning to innovative payment models and manages the implementation of cross-functional organizational strategies to improve provider and member experience.
• Serves as a subject matter expert on competitive intelligence, supports development of innovative

Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Number of Employees: 1,001-5,000 employees