Provider Network Executive III

What you’ll do: Develop and execute ongoing account management and service strategy to meet corporate strategic and financial objectives. Serve as the main point of contact for providers and coordinate all Premera interactions with assigned accounts. Build and maintain positive physician/provider relationships, generally with more complex accounts. Utilize consultative skills, industry knowledge, and Premera product knowledge to foster a collaborative approach to quality care, network stability, and cost containment. Monitor and analyze network performance. Develop and maintain effective provider networks (standard and custom) with complex payment methodologies. Participate in payment and delivery systems innovation initiatives. Lead negotiation and implementation of complex or custom provider contracts. Complete negotiations within preplanned rate targets, meet timelines, ensure established implementation period, and perform implementation audits for accuracy of assigned accounts. Collaborate with Healthcare Economics in rate development and proposal analysis. Establish and lead a multi-disciplinary team to provide operationally excellent service and support to assigned accounts. Consult and educate assigned accounts and internal stakeholders, providing industry and cross‑account expertise. Create provider‑specific and public presentations. Proactively communicate with Provider Strategy & Solutions (PS&S) leadership and internal stakeholders on account status to facilitate proper internal support of account management efforts. Engage providers to promote patient engagement adherence, cost‑saving preventative programs. Perform other duties and projects as assigned. What you’ll bring: Minimum four (4) years of experience in a provider or payer environment (required). Four (4) years of experience in payer or provider contracting and managing provider relationships in the health care or insurance industry. Two (2) years of experience negotiating contracts (required). Master’s degree in a related field (preferred). Project management experience (preferred). Hospital contract negotiation experience (preferred). Working knowledge of HIPAA, NCQA, government health care programs, and risk coding. Knowledge of network development and provider/vendor network recruitment. Knowledge of provider community and market anomalies. Demonstrated ability to manage complex contract negotiations, develop and execute strategy, and lead and direct teams addressing complex issues. Strong experience and expertise in Provider Relations. Independent work style, self‑motivation, and ability to lead with minimal direction. Excellent verbal and written communication skills, including public presentations, training, meeting facilitation, and broker presentations. Strong analytical, problem‑solving, interpersonal, organizational, planning, and administrative skills. Ability to work under pressure with tight timelines, limited resources, competing priorities, and specific project deadlines. Benefits Medical, vision, and dental coverage with low employee premiums. Voluntary benefit offerings, including pet insurance. Life and disability insurance. Retirement programs, including a 401(k) employer match and a pension plan vested after three years of service. Wellness incentives and mental well‑being resources, counseling services, stress management, mindfulness programs, and more. Generous paid time off. Tuition assistance for undergraduate and graduate degrees. Employee recognition program celebrating anniversaries, team accomplishments, and more. Hybrid work model with on‑campus flexibility and resources. Commuter perks, free on‑site parking, subsidized campus cafes. On‑site fitness & well‑being center with in‑person and virtual workouts and nutritional counseling. Equal Employment Opportunity Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information, or any other protected characteristic under applicable law. If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at View email address on click.appcast.io or by phone at View phone number on click.appcast.io. #J-18808-Ljbffr Premera