Provider Contracting Executive Senior

Cambia Health Solutions

Renton, WA

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JOB DETAILS

SALARY

$100,300–$135,700 Per Year

JOB TYPE

Full-time, Employee

SKILLS

Analysis Skills, Artificial Intelligence (AI), Business Growth, Communication Skills, Contract Management, Contract Negotiation, Cost Effectiveness Analysis, Data Analysis, Diagnosis-Related Group (DRG), Financial Analysis, Funding, Health Economics, Health Plan, Healthcare, Healthcare Providers, Healthcare Reimbursement, Internet/Online Service, Investment Management, Leadership, Leading Edge Technology, Loans, Managed Care, Mentoring, Negotiation Skills, Network Administration/Management, Network Configuration Management, Network Support, Performance Management, Pricing, Product Positioning, Product Pricing, Product Profitability, Product/Service Launch, Provider Contracting, Provider Relations, Quality of Care, Reimbursement, Resource-Based Relative Value Scale (RBRVS), Risk Management, Strategic Planning, Systems Maintenance, Team Player

LOCATION

Renton, WA

POSTED

30+ days ago

Hybrid opportunities in Renton, Burlington, Spokane or Tacoma, Washington

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 Executive Senior 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 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.

The expected hiring range for a Provider Contracting Executive Senior is $100,300 - $135,700 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for the Provider Contracting Executive Senior position is 15%.The current full salary range for the Provider Contracting Executive Senior is $94,000 - $154,000. #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.

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 CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.\n \nApply here: https://www.aplitrak.com/?adid=YmJnZW5lcmljLjkwOTY3Ljg3NjlAY2FtYmlhaGVhbHRoY29tcC5hcGxpdHJhay5jb20

About the Company

Cambia Health Solutions

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