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Provider Relations Executive

$66k - $90k
Full-time

Cambia Health Solutions

Provider Relations Executive Hybrid role at our Fargo, Bismarck, Grand Forks, Jamestown or Minot, North Dakota 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 Relations Executives are living our mission to make health care easier and lives better. As a member of the Provider Relations team, our Provider Relations Executives serve as the primary point of contact for assigned providers, overseeing education, communication, vendor integration, and performance within Alternative Payment Models (APMs). Drives healthcare transformation by fostering cross-functional partnerships that improve quality, cost, and experience while ensuring network stability and provider success – all in service of creating an economically sustainable health care system. Do you have a passion for driving healthcare transformation and building meaningful relationships with providers? Are you energized by managing complex partnerships and helping others succeed in innovative payment models? If so, this role may be the perfect fit. What You Bring to Cambia: Qualifications: Provider Relations Executive would have a Bachelor's degree in Healthcare Administration or related field and a minimum of 5 years of experience in the healthcare industry with specific focus in provider relations, provider contracting, customer service, financial analysis: Provider/payer strategy development or implementation; Provider/payer contracting and reimbursement, preferably managed care; delivery system administration, or equivalent combination of education and experience. Valid driver's license is required. Skills and Attributes: Deep understanding of the provider community, healthcare delivery systems, coding, reimbursement, and Alternative Payment Models (APMs) Excellent communication, facilitation, and presentation skills across diverse audiences and organizational levels Strong consulting, influencing, and change management abilities with a professional presence Self-directed critical thinker with strong initiative, prioritization, and deadline management skills Ability to navigate conflict, ambiguity, and total cost of care considerations effectively Proficiency with Microsoft Office tools, with experience in AI technologies to enhance productivity and decision-making highly desired Ability to travel extensively within state What You Will Do at Cambia: Develops and maintains collaborative partnerships with providers and internal stakeholders as a trusted advisor, documenting relationships and tracking performance metrics Maintains deep knowledge of Cambia programs and serves as a subject matter expert, educating stakeholders on the provider landscape and innovative payment models Facilitates Joint Operating Committees and work groups to drive improved outcomes and provider engagement in strategic programs, including Medicare Advantage activities Identifies and supports initiatives to transition providers from Fee-for-Service to value-based and innovative payment models Manages implementation of cross-functional strategies to enhance provider and member experience Develops and delivers education programs tailored to diverse provider and stakeholder audiences Represents the health plan at external meetings and resolves escalated issues to maintain network stability and trust 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. North Dakota: The expected hiring range is $66,000 -$90,000 and the full salary range is $59,716 - $95,546. #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. 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. If you need accommodation for any part of the application process because of a medical condition or disability, please email View email address on click.appcast.io. 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.

Vacancy posted 20 hours ago
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