Provider Contracting Executive or Senior, DOE
Hybrid role (3 days/week in office) at our Salt Lake City, Boise, Fargo, Portland, Vancouver, Renton, Medford, Burlington, Lewiston, Little Rock, and Springdale offices.
Preference will be given to current employees and candidates who reside within a commutable distance from our Salt Lake City, Boise, Fargo, Lewiston, Little Rock, and Springdale offices, or who are willing to relocate.
Qualifications:
- The Provider Contracting Executive would have a Bachelor's Degree in healthcare, business or a related field and 5 years' experience in a healthcare industry provider contracting, relations, or analytical capacity or equivalent combination of education and experience.
- The Provider Contracting Executive Senior would have a Bachelor's Degree in healthcare, business or a related field and 7 years' experience in a healthcare industry provider contracting, relations or analytical capacity or equivalent combination of education and experience.
Skills and Attributes:
- Strong understanding of managed care and accountable health system models and relationship to contracting strategy and reimbursement methodology.
- Proven ability to build positive relationships and negotiate successfully with institutional, professional, and ancillary providers.
- Demonstrated competency related to varying payment methodologies and value base contracting. (such as Pay for Quality/Performance, DRG, APC, ASC, Capitation, Fee for Service, RBRVS, Per Diem, Per Case)
- Ability to analyze financial, quality, and utilization data and use to develop contracting strategies. Ability to organize and manage a portfolio of contracts.
- Ability to work in high-pressure circumstances and effectively manage conflict and ambiguity. Senior Provider Contracting (requirements in addition to above)
- Proficiency building relationships and negotiating successfully with large and complex market-leading institutional and professional providers.
- Ability to independently and effectively communicate with high level executives internally and externally.
- Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired
What You Will Do at Cambia:
Provider Contracting Executive- Maintains and expands the health care delivery system network by negotiating contracts and cultivating provider relationships that support cost effectiveness, quality of care, enrollment growth, administrative efficiency, product positioning, and profitability.
- Develops long- and short-range contracting strategies for each assigned delivery system.
- Monitors the financial and utilization performance of contracts and partners with the Health Care Services division to develop improvement plans.
- Meets regularly with key provider leaders as the primary "client manager" to review cost and utilization reports, prepare analyses, research issues, and recommend strategies.
- Builds and maintains regional networks to support new products, applying strong knowledge of market pricing and communicating the strategic benefits of participation to providers.
- Works with provider consultants and representatives to ensure contracts are administered appropriately and improvement plans are managed.
- Supports initiatives that reduce healthcare expenditures while preserving the best possible care for members, based on potential savings and impact on members and providers.
- Develops and manages risk arrangements, including pricing and accountable health system funding arrangements.
Provider Contracting Executive Senior- Strong understanding of managed care and accountable health system models, and how they relate to contracting strategy and reimbursement methodology.
- Proven ability to build positive relationships and negotiate successfully with institutional, professional, and ancillary providers.
- Demonstrated competency with varying payment methodologies and value-based contracting, such as Pay for Quality/Performance, DRG, APC, ASC, Capitation, Fee for Service, RBRVS, Per Diem, and Per Case.
- Ability to analyze financial, quality, and utilization data to develop contracting strategies, and to organize and manage a portfolio of contracts.
- Ability to work in high-pressure circumstances and effectively manage conflict and ambiguity.
- Senior level (in addition to above): Proficiency building relationships and negotiating successfully with large, complex, market-leading institutional and professional providers.
- Senior level (in addition to above): Ability to communicate independently and effectively with high-level executives, both internally and externally.
Pay ranges vary based on the candidate's work location. The expected hiring range depends on skills, experience, education, and training; relevant licensure / certifications; and performance history.
National pay structure - applies to the Boise and Lewiston, ID; Salt Lake City, UT, Oregon and Washington. The full salary range for the
Provider Contracting Executive is $80,000 - $130,00and the bonus target is 10%. The expected offer salary range is $85,000 - $115,000.
Regional pay structure - applies to North Dakota and Arkansas, as well as Idaho and Utah locations outside the metro areas listed above: The full salary range for the
Provider Contracting Executive is $72,00 - $117,000 and the bonus target is 10%. The expected offer salary range is $76,500 - $103,500.
National pay structure - applies to the Boise and Lewiston, ID; Salt Lake City, UT, Oregon and Washington. The full salary range for the
Provider Contracting Executive Senior is $96,000 - $156,000 and the bonus target is 15%. The expected offer salary range is $102,000 - $138,000.
Regional pay structure - applies to North Dakota and Arkansas, as well as Idaho and Utah locations outside the metro areas listed above: The full salary range for the
Provider Contracting Executive Senior is $86,000 - $141,000 and the bonus target is 15%. The expected offer salary range is $91,800 - $124,200.
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.
As part of our security requirements, new hires will need access to a personal mobile device to set up Multi-Factor Authentication (MFA) upon joining the company. MFA is an important layer of protection for accessing Cambia systems and is required for all employees.
