Provider Relations Executive
About The Position
Provider Relations Executive Hybrid role at our Fargo, Bismarck, Grand Forks, Jamestown or Minot, North Dakota offices. Candidates must reside within commutable distance of that location or be willing to relocate. Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. 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 Relations team, our Provider Relations Executives serve as the primary point of contact for assigned providers, overseeing education, communication, vendor integration, and performance within Alternative Payment Models (APMs). Drives healthcare transformation by fostering cross-functional partnerships that improve quality, cost, and experience while ensuring network stability and provider success – all in service of creating an economically sustainable health care system.
Requirements
- 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
- Deep understanding of the provider community, healthcare delivery systems, coding, reimbursement, and Alternative Payment Models (APMs)
- Excellent communication, facilitation, and presentation skills across diverse audiences and organizational levels
- Strong consulting, influencing, and change management abilities with a professional presence
- Self-directed critical thinker with strong initiative, prioritization, and deadline management skills
- Ability to navigate conflict, ambiguity, and total cost of care considerations effectively
- Proficiency with Microsoft Office tools
- Ability to travel extensively within state
Nice To Haves
- Experience in AI technologies to enhance productivity and decision-making highly desired
Responsibilities
- Develops and maintains collaborative partnerships with providers and internal stakeholders as a trusted advisor, documenting relationships and tracking performance metrics
- Maintains deep knowledge of Cambia programs and serves as a subject matter expert, educating stakeholders on the provider landscape and innovative payment models
- Facilitates Joint Operating Committees and work groups to drive improved outcomes and provider engagement in strategic programs, including Medicare Advantage activities
- Identifies and supports initiatives to transition providers from Fee-for-Service to value-based and innovative payment models
- Manages implementation of cross-functional strategies to enhance provider and member experience
- Develops and delivers education programs tailored to diverse provider and stakeholder audiences
- Represents the health plan at external meetings and resolves escalated issues to maintain network stability and trust
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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
