Vice President Contracting, Oregon/WashingtonHybrid role (3 days/week in office) at our Portland, Vancouver, or Renton offices. Candidates should reside within a commutable distance from our Portland, Vancouver, or Renton offices or be willing to relocate.
Qualifications:- Master's degree in Business, Health Care Administration, Public Health or a related field and 15 years of broad health care and medical management leadership experience, with at least 7 years of healthcare payer experience, or an equivalent combination of education and experience
- Experience converting providers from fee-for-service to value-based contracts for commercial, Medicare, and Medicaid required
Skills and Attributes:- Demonstrated development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
- Deep expertise in health insurance industry trends, reimbursement methods, and evolving accountable care and payment models
- Broad end-to-end experience with medical care management including product design, provider contracting, utilization management, care management, quality, and go-to-market strategies
- Demonstrated success in contract negotiation and managing relationships with hospitals, provider groups, and integrated delivery systems
- Demonstrated ability to leverage AI tools and resources to drive efficiency and innovation within area of expertise
- Deep business acumen including understanding of market dynamics, financial/budget management, data analysis, and decision-making
- Demonstrated competency in creating and executing business strategies and driving results within a large, complex organization and/or with external partners
- Innovative thinker with the ability to articulate a vision, manage complexity, and lead change
- Strong communication and facilitation skills across all levels of the organization and with executive-level external partners, including the ability to resolve issues and build consensus among diverse stakeholders
- Demonstrated ability to lead high-performing teams and develop leaders
What You Will Do at Cambia:- Direct the provider network and contracting activities. Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers with analysis related to reimbursement and unit cost management. Oversee the coordination and negotiation for the contracting department.
- Provide executive leadership for Provider negotiation strategy and oversee operational execution in partnership with internal and external stakeholders to achieve stated objectives
- Provide leadership in evaluating opportunities to expand or change the network to meet Company goals
- Partner with company-wide and market-based leaders to develop and execute short and long-range plans related to provider network strategy, contracting, provider satisfaction, quality, and cost
- Ensure networks support affordability, geographic coverage, marketability, and satisfaction goals while maintaining productive relationships between health plan and delivery system leadership
- Champion best practices, innovative healthcare and cost-sharing models, and performance improvement priorities, including developing metrics and reporting protocols to monitor and communicate results
- Partner with Health Care Services and other leaders to create effective new products, programs, and services that achieve marketing, sales, and operational objectives
- Determine appropriate resource needs and allocate resources across departments and projects
- You bring unique value to our community of 200 leaders running our company. By actively engaging with your peers and inspiring your teams, you play an essential role in making health care easier and lives better.
Oregon, Washington, Utah, and Idaho: The expected hiring range is $262,650-355,350, the full salary range is $224,000-366,000, and the bonus target is 30%.
