Senior Provider Engagement Consultant

Cambia Health Solutions

5d • Hybrid

About The Position

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.

Requirements

• Bachelor's degree (Master's preferred) in Business Administration, Healthcare Administration or related field
• 8 years relevant experience in a large healthcare delivery, health insurance or health care consulting organization
• Specific experience building provider partnerships and/or value-based agreements
• 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
• 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.

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: Senior