Provider Contracting Executive or Senior, DOE

Provider Contracting Executive or Senior, DOE

Work from home within Portland, OR area

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 or Senior's 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.

• 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.

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.

• Develops 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 new contractors and others within the department, providing resources and guidance to support the organization's objectives.

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 (eligible day one of employment if within first 12 months following birth or adoption). 

• 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 and Affirmative Action employer dedicated to workforce diversity and 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 [email protected]. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.