Senior Provider Engagement Consultant

Cambia Health Solutions • Washington, DC

1d • Hybrid

About The Position

Senior Provider Engagement Consultant Hybrid opportunity within Portland, OR; Medford, OR; Salt Lake City, UT; Lewiston, ID; Boise, ID; Renton, WA; Burlington, WA; Vancouver, WA; Spokane, WA. Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system. Who We Are Looking For: Every day, Cambia’s dedicated team of Provider Engagement Consultants are living our mission to make health care easier and lives better. As a member of the Network Management team, our Senior Provider Engagement Consultants serves as the primary strategic liaison between Cambia and key Medicare Advantage providers, leading cross-functional teams to drive provider performance in cost, quality, risk, and member experience. This role provides strategic leadership and decision-making support to achieve short and long-term business objectives through consistent provider relationship management and collaboration – all in service of making our members’ health journeys easier. Do you have a passion for building strategic partnerships and driving measurable results in healthcare? Do you thrive in a collaborative environment where you can lead cross-functional teams to achieve shared goals? Then this role may be the perfect fit. What You Bring to Cambia: Qualifications: Provider Engagement Consultant Sr. would have a bachelor's degree (Master's preferred) in Business Administration, Healthcare Administration or related field and 8 years relevant experience in a large healthcare delivery, health insurance or health care consulting organization with specific experience building provider partnerships and/or value-based agreements or equivalent combination of education and experience. Skills and Attributes: Deep knowledge of health insurance industry trends, integrated finance and delivery models, and evolving accountable care and payment models, with experience in both provider and payor organizations Executive presence with proven ability to lead change, influence stakeholders, and navigate highly matrixed organizations to improve operating and strategic positions Strong business acumen including strategic planning, financial/budget management, market dynamics analysis, and data-driven decision making Demonstrated success supporting complex business initiatives and driving results across internal teams and external partners Excellent consulting, communication, and facilitation skills at all organizational levels, with ability to influence and build lasting relationships Proficiency in Microsoft Office tools with proven ability to present analytical data and research findings for effective decision-making Strategic thinking capability to see the big picture, approach business problems innovatively, and clarify key issues in complex situations Experience with AI tools and technologies to enhance productivity and decision-making highly desired What You Will Do at Cambia: Develops and drives strategic direction for assigned provider groups related to Medicare Advantage and commercial APM objectives Serves as primary point of contact for key provider groups, partnering with market provider relations teams Executes engagement strategies including Medicare Stars, risk adjustment, and clinical initiatives Leads cross-functional Cambia teams to achieve provider performance targets in quality, utilization, and member experience Collaborates with provider organization leaders to drive successful performance in APM arrangements Acts as subject matter expert on Medicare, value-based care models, and APM performance Supports senior leadership on special projects advancing Cambia's value-based and innovative provider relationships The expected hiring range for a Senior Provider Engagement Consultant is $111,400 - $120,000 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15%. The current full salary range for this role is $104,000 - $171,000. #LI-hybrid About Cambia Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through. Why Join the Cambia Team? At Cambia, you can: Work alongside diverse teams building cutting-edge solutions to transform health care. Earn a competitive salary and enjoy generous benefits while doing work that changes lives. Grow your career with a company committed to helping you succeed. Give back to your community by participating in Cambia-supported outreach programs. Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck – and your compensation should be too. Our compensation package includes competitive base pay as well as a market-leading 401(k) with a significant company match, bonus opportunities and more. In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include: 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. Learn more about our benefits. We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required. If you need accommodation for any part of the application process because of a medical condition or disability, please email [email protected]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. Everyone is a health care consumer deserving of a simpler, more personalized experience. Cambia is transforming the health care system to revolve around people. For over 100 years we’ve designed people-first health solutions rooted in the nation’s first health plan, a loggers’ wage pool established in the Pacific Northwest. Today that pioneering spirit aligns our family of over 20 companies, including 4 not-for-profit BlueCross and BlueShield licensed health plans serving over 3 million Americans. Cambia blends data science with a compassionate human perspective to anticipate people’s needs, and empower them to make smarter health care choices. Interested in driving accessibility, affordability and quality health care for real people? Apply to any of our open jobs or join the Twitter conversation @Cambia. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.

Requirements

• Provider Engagement Consultant Sr. would have a bachelor's degree (Master's preferred) in Business Administration, Healthcare Administration or related field and 8 years relevant experience in a large healthcare delivery, health insurance or health care consulting organization with specific experience building provider partnerships and/or value-based agreements or equivalent combination of education and experience.
• Deep knowledge of health insurance industry trends, integrated finance and delivery models, and evolving accountable care and payment models, with experience in both provider and payor organizations
• Executive presence with proven ability to lead change, influence stakeholders, and navigate highly matrixed organizations to improve operating and strategic positions
• Strong business acumen including strategic planning, financial/budget management, market dynamics analysis, and data-driven decision making
• Demonstrated success supporting complex business initiatives and driving results across internal teams and external partners
• Excellent consulting, communication, and facilitation skills at all organizational levels, with ability to influence and build lasting relationships
• Proficiency in Microsoft Office tools with proven ability to present analytical data and research findings for effective decision-making
• Strategic thinking capability to see the big picture, approach business problems innovatively, and clarify key issues in complex situations

Nice To Haves

• Experience with AI tools and technologies to enhance productivity and decision-making highly desired

Responsibilities

• Develops and drives strategic direction for assigned provider groups related to Medicare Advantage and commercial APM objectives
• Serves as primary point of contact for key provider groups, partnering with market provider relations teams
• Executes engagement strategies including Medicare Stars, risk adjustment, and clinical initiatives
• Leads cross-functional Cambia teams to achieve provider performance targets in quality, utilization, and member experience
• Collaborates with provider organization leaders to drive successful performance in APM arrangements
• Acts as subject matter expert on Medicare, value-based care models, and APM performance
• Supports senior leadership on special projects advancing Cambia's value-based and innovative provider relationships

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: Mid Level
• Number of Employees: 1,001-5,000 employees