Provider Relations Executive

Blue Cross Blue Shield of North Dakota•Fargo, ND

7d•$60,000 - $77,000•Hybrid

About The Position

This role manages the full provider experience for assigned providers, including education, communication, Alternative Payment Models (APMs) performance, vendor integration, and relationship building. The goal is to drive healthcare transformation to improve quality, cost, and experience by enabling provider success in Cambia's APMs and innovative initiatives. This involves managing cross-functional relationships to support effective partnerships and maintain network stability. The company is an insurance provider that also works to challenge the cost and complexity of healthcare in North Dakota, aiming to create a new level of health and well-being.

Requirements

Deep understanding of provider community and healthcare delivery systems
Excellent communication and facilitation skills
Self-directed with creative critical thinking abilities
Professional presence and change management knowledge
Strong consulting and influencing skills at all organizational levels
Presentation skills for various settings and audiences
Initiative, prioritization, and deadline management
Knowledge of provider coding, reimbursement, and APMs
Understanding of total cost of care factors
Ability to manage conflict and ambiguity
Proficiency with Microsoft Office tools
Ability to travel extensively within state
Bachelor's degree in Healthcare Administration or related field
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.

Nice To Haves

Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

Responsibilities

Develops collaborative partnerships with providers and internal stakeholders as a trusted advisor
Documents provider relationships and tracks performance metrics
Maintains knowledge of Cambia programs and educates stakeholders
Facilitates Joint Operating Committees and work groups to improve outcomes
Drives provider engagement in strategic programs including Medicare Advantage activities
Identifies initiatives to help providers transition from Fee for Service to innovative payment models
Manages implementation of cross-functional strategies to improve provider and member experience
Develops education programs and serves as subject matter expert on provider landscape
Represents the health plan at external meetings and resolves escalated issues

Benefits

Affordable medical, dental and vision coverage accepted throughout the United States
Employer funded Lifestyle Spending Accounts and Health Savings Accounts.
Voluntary employee contributions to Health Savings Accounts and Flexible Spending Accounts
Employer-paid life and disability insurance
401(k) retirement plan with company match and immediate vesting
Paid holidays, paid time off (PTO), PTO donation program, and paid parental leave
Voluntary benefits including Accident, Hospital Indemnity, Critical Illness, Term/Whole Life, Cancer Care Insurance, and more.
Robust mental health offerings including an Employee Assistance Program, Learn to Live, meQ.
Comprehensive learning and development opportunities and an Educational Assistance Program.
16 hours of paid volunteer time with a $200 donation to a charity of your choice upon completion of all volunteer hours.
Employee recognition, community initiative events and yearly company outings.
Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments.
Opportunities to connect through employee committees.