Provider Contracting Executive or Senior, DOE

Cambia Health Solutions, Inc.; Boise (ID); Híbrido; USD 80.000 - 130.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental and vision coverage

401(k) with company match

Generous paid time off

Parental leave

Wellness programs

Employee Assistance Fund

Commuter and parking benefits

Descripción de la vacante

Cambia Health Solutions, Inc. is hiring a Provider Contracting Executive/Senior to lead contract negotiations and strategic relationships with physicians, groups, and institutions across multiple offices.

This role combines analytics, negotiation, and leadership to drive cost efficiency and quality outcomes. The position supports strategic contracting programs, collaborates with health services teams, and advances value-based reimbursement methodologies in a collaborative, results-driven

Formación

• Bachelor's degree in healthcare, business or related field; 5+ years in provider contracting/relations/analytics.
• Senior: 7+ years in provider contracting/relations/analytics and related work.
• Experience negotiating with large institutional providers or complex networks is preferred.

Responsabilidades

• Negotiate contracts and manage provider relationships to improve cost, quality, and enrollment.
• Develop long- and short-range contracting strategies for assigned delivery systems.
• Monitor contract financials and utilization; present findings to leadership.
• Meet with provider leaders to review cost/utilization and drive improvement plans.
• Support regional and national pay structures and implement value-based contracting strategies.

Conocimientos

Negotiation

Relationship management

Data analysis

Contracting strategy

Executive communication

AI tools familiarity

Educación

Bachelor's Degree in healthcare or business

Herramientas

AI tools

Descripción del empleo

Provider Contracting Executive or Senior, DOE Hybrid role (3 days/week in office) at our Salt Lake City, Boise, Fargo, Portland, Vancouver, Renton, Medford, Burlington, Lewiston, Little Rock, and Springdale offices.

Preference will be given to current employees and candidates who reside within a commutable distance from our Salt Lake City, Boise, Fargo, Lewiston, Little Rock, and Springdale offices, or who are 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 Network Management team, our Provider Contracting Executives manage contracting relationships with physicians, physician groups, institutions, and ancillary providers, overseeing strategy development, analytical support, negotiation, and administration. They also build and maintain relationships with key providers while promoting innovative products and reimbursement methodologies – all in service of creating an economically sustainable health care system.

Are you skilled at negotiating win-win agreements and turning complex data into smart contracting strategies? Do you enjoy building trusted relationships with providers and exploring innovative approaches to reimbursement? Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.

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 understanding of managed care and accountable health system models and relationship to contracting strategy and reimbursement methodology.
• Proven ability to build positive relationships and negotiate successfully with institutional, professional, and ancillary providers.
• Demonstrated competency related to varying payment methodologies and value base contracting. (such as Pay for Quality/Performance, DRG, APC, ASC, Capitation, Fee for Service, RBRVS, Per Diem, Per Case)
• Ability to analyze financial, quality, and utilization data and use to develop contracting strategies.
• Ability to organize and manage a portfolio of contracts.
• Ability to work in high-pressure circumstances and effectively manage conflict and ambiguity.

Senior Provider Contracting (requirements in addition to above)

• Proficiency building relationships and negotiating successfully with large and complex market-leading institutional and professional providers.
• Ability to independently and effectively communicate with high level executives internally and externally.
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

What You Will Do at Cambia

• Provider Contracting Executive Maintains and expands the health care delivery system network by negotiating contracts and cultivating provider relationships that support cost effectiveness, quality of care, enrollment growth, administrative efficiency, product positioning, and profitability.
• Develops long- and short-range contracting strategies for each assigned delivery system.
• Monitors the financial and utilization performance of contracts and partners with the Health Care Services division to develop improvement plans.
• Meets regularly with key provider leaders as the primary "client manager" to review cost and utilization reports, prepare analyses, research issues, and recommend strategies.
• Builds and maintains regional networks to support new products, applying strong knowledge of market pricing and communicating the strategic benefits of participation to providers.
• Works with provider consultants and representatives to ensure contracts are administered appropriately and improvement plans are managed.
• Supports initiatives that reduce healthcare expenditures while preserving the best possible care for members, based on potential savings and impact on members and providers.
• Develops and manages risk arrangements, including pricing and accountable health system funding arrangements.
• Provider Contracting Executive Senior Strong understanding of managed care and accountable health system models, and how they relate to contracting strategy and reimbursement methodology.
• Proven ability to build positive relationships and negotiate successfully with institutional, professional, and ancillary providers.
• Demonstrated competency with varying payment methodologies and value-based contracting, such as Pay for Quality/Performance, DRG, APC, ASC, Capitation, Fee for Service, RBRVS, Per Diem, and Per Case.
• Ability to analyze financial, quality, and utilization data to develop contracting strategies, and to organize and manage a portfolio of contracts.
• Ability to work in high-pressure circumstances and effectively manage conflict and ambiguity.
• Senior level (in addition to above): Proficiency building relationships and negotiating successfully with large, complex, market-leading institutional and professional providers.
• Senior level (in addition to above): Ability to communicate independently and effectively with high-level executives, both internally and externally.

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.

National pay structure — applies to the Boise and Lewiston, ID; Salt Lake City, UT, Oregon and Washington.

The full salary range for the Provider Contracting Executive is $80,000 - $130,00and the bonus target is 10%.

The expected offer salary range is $85,000 - $115,000.

Regional pay structure — applies to North Dakota and Arkansas, as well as Idaho and Utah locations outside the metro areas listed above:

The full salary range for the Provider Contracting Executive is $72,00 - $117,000 and the bonus target is 10%.

The expected offer salary range is $76,500 - $103,500.

National pay structure — applies to the Boise and Lewiston, ID; Salt Lake City, UT, Oregon and Washington.

The full salary range for the Provider Contracting Executive Senior is $96,000 - $156,000 and the bonus target is 15%.

The expected offer salary range is $102,000 - $138,000.

Regional pay structure — applies to North Dakota and Arkansas, as well as Idaho and Utah locations outside the metro areas listed above:

The full salary range for the Provider Contracting Executive Senior is $86,000 - $141,000 and the bonus target is 15%.

The expected offer salary range is $91,800 - $124,200.

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 [e-mail].

Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.

Cambia Health Solutions is a family of companies headquartered in Portland, Oregon, working to make healthcare simpler, more affordable and more person-focused. Through our regional health insurance plans, innovative technologies and strategic investments, we are delivering consumer-centric solutions that:

• Help people achieve better health and well-being
• Make healthcare more available, affordable, and personalized
• Are easily understood by everyone

We put people at the heart of everything we do. Our company reaches more than 70 million Americans nationwide, including more than 6 million people enrolled in our regional health plans. 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?

Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy.