Provider Contracting Executive or Senior, DOE

Provider Contracting Executive or Senior, DOE Hybrid role at our Renton, Tacoma, Spokane, Vancouver and Burlington, WA 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. Who We Are Looking For: Every day, Cambia’s dedicated team of Provider Contracting Executives are living our mission to make health care easier and lives better. As a member of the Provider Contracting team, our Provider Contracting Executives lead the development and management of strategic contracting relationships with top-tier physicians, groups, institutions, and ancillary providers. Drive business growth through innovative products and reimbursement methodologies, while cultivating and maintaining key relationships and overseeing complex contract negotiations and administration – all in service creating a person-focused health care experience. Do you have a passion for serving others and driving business growth? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit. What You Bring to Cambia: 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 industry knowledge: Strong understanding of managed care and accountable health system models, and their relationship to contracting strategy and reimbursement methodology. Negotiation and relationship-building skills: Proven ability to build positive relationships and negotiate successfully with institutional, professional, and ancillary providers. Payment methodology expertise: Demonstrated competency in varying payment methodologies, including Pay for Quality/Performance, DRG, APC, ASC, Capitation, Fee for Service, RBRVS, Per Diem, and Per Case. Strong understanding of value-based programs and contracting models. Proficiency and comfort in negotiating complex contract language. Data analysis and strategy development: Ability to analyze financial, quality, and utilization data to develop contracting strategies and manage a portfolio of contracts. High-pressure environment skills: Ability to work effectively in high-pressure circumstances, managing conflict and ambiguity. Senior-level negotiation and communication skills: Proficiency in building relationships and negotiating successfully with large, complex, and market-leading institutional and professional providers, and ability to independently and effectively communicate with high-level executives internally and externally. Leadership and portfolio management: Ability to oversee and manage a portfolio of contracts and provide leadership and guidance to others in the organization. Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired What You Will Do at Cambia: Maintains and expands the health care delivery system network by negotiating contracts and maintaining relationships with providers, positioning the organization to meet its objectives relating to cost effectiveness, quality of care, enrollment growth, administrative efficiency, product positioning, and profitability. Monitors financial and utilization performance of contracts, develops plans to improve performance, and meets with key provider leaders to review reports, prepare analysis, and recommend strategies. Develops and maintains new regional networks to support the introduction of new products, understanding health plan market pricing and communicating strategic benefits to providers. Collaborates with provider consultants and representatives to ensure contracts are administered appropriately and improvement plans are managed. Develops and manages risk arrangements, including pricing and accountable health system funding arrangements, and leads plan initiatives/pilots focused on provider network configuration, reimbursement, and management. Develop long and short-range contracting strategies for each delivery system assigned, with a focus on reducing healthcare expenditures while delivering high-quality care to members. Serves as a mentor to Provider Contracting Executives and others within the department, providing resources and guidance to support the organization's objectives. Pay ranges vary based on the candidate's work location: Oregon, Washington, Utah, and Idaho: The expected hiring range for the Provider Contracting Executive is $84,200 - $113,900 and for a Provider Contracting Executive Senior is $101,200 - $136,900. The bonus target for the Provider Contracting Executive position is 10%. The bonus target for the Provider Contracting Executive Senior position is 15%. The current full salary range for the Provider Contracting Executive role is $79,000 - $129,000 and the Provider Contracting Executive Senior is $95,000 - $155,000. 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? 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. 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. 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. 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? #J-18808-Ljbffr Cambia Health Solutions