Provider Partnership Strategist
PacificSource
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Benefits offered by this job
Job summary
PacificSource in Oregon seeks a senior strategist to provide oversight for complex provider partnerships, shaping initiatives that improve cost, quality, and member outcomes. You will collaborate with physicians, executives, and cross‑functional teams to implement plans and educate providers on products and procedures.
The role involves building relationships, analyzing data, delivering provider reports, and guiding region specific strategies.
Qualifications
- BA/BS in business, health care administration, finance, or equivalent work experience desired.
- Experience in Project Management preferred.
Responsibilities
- Manage initiatives and projects resulting from partner opportunities across lines of business.
- Provide training and high‑touch support to network system providers and staff for improvement activities.
- Collaborate with multiple departments to deploy aligned initiatives and enhance workflows for provider partner satisfaction.
- Track project progress and communicate to JOC participants; manage schedule, timelines, and milestones.
- Provide education to applicable Providers on PacificSource products and procedures.
- Present data and provider reporting to stakeholders and identify opportunities for improvement.
Skills
Education
Tools
Job description
Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.
Responsible for providing strategic oversight for designated complex provider partnerships, positively impacting operational efficiencies, cost, quality, and improved health outcomes. Work collaboratively with other PacificSource stakeholders and external partnership representatives, such as physicians, executive management, JOC work stream leaders (Quality, Health Services, IT, Analytics, Risk Adjustment, Pharmacy), and clinical/office staff, to create a plan of collaboration, implementation and success for JOC initiatives. Ensure consistency and collaboration with providers and internal stakeholders, as well as serve as a primary point of contact for JOC facilitation. This position works to build/strengthen relationships with strategic provider partners by ensuring effective education, analyzing and generating specific reports, and proactively identifying improvement opportunities that support PacificSource’s strategic goals. This position also assists with the development and execution of region‑specific strategies and coaching.
- Manage for ongoing or to completion: initiatives, activities and projects resulting from partner and PacificSource identified opportunities, with engagement across all lines of business.
- Provide ongoing training, coaching and high‑touch support to network system providers and staff toward the development and implementation of improvement activities to support process improvement from PacificSource and external partner.
- Collaborate with multiple departments to develop and deploy aligned initiatives, process improvement activities, and enhance workflows to improve provider partner satisfaction and streamline processes for better member care outcomes and service.
- Track project progress and communicate to JOC participants and other stakeholders; develop and manage JOC schedule; timelines, activities, and milestones.
- Provide direct provider support through contracting auditing, working as a liaison with internal departments to support improved processes with claims processing, facilities, group and provider set up.
- Provide education to applicable Providers on PacificSource products, administrative procedures, legislative, and compliance requirements.
- Work directly with Provider Network and other departmental leadership to advance JOC initiatives, working closely with other work stream leaders including Contracting, Health Services, Pharmacy, Analytics, IT, Population Health and Risk Adjustment.
- Work with internal stakeholders and business owners to present and review data and deliver provider reporting packages.
- Assist in identifying opportunities/trends, tools, and proposed course of action to help meet incentive, quality, and operational goals as appropriate.
- Work with consultants and various areas of hospital(s) - finance, clinic managers, billing supervisory staff, Utilization, Credentialing -to develop a strategic direction based off of current processes and opportunities.
- Create and help execute a collaborative roadmap to accomplish established goals.
- Prepare materials and presentations for meetings, with the assistance of the Provider Relations Representative, Quality Coordinator, and other applicable personnel.
- Conduct/participate in group operational meetings.
- Receive, analyze, and respond to provider issues and assure timely, appropriate follow‑up.
- Work to identify potential trend issues and seek resolution(s).
- Serve as a provider contact and problem solver for a wide range of issues including, but not limited to; claims, operational, encounter, quality, risk provider, clinic, billing, health services notifications, capitation/financial, contractual details and any data/reporting needs.
- Understand contracting methodologies and terms for all lines of business.
- Proactively develop positive working relationships with other PacificSource departments and staff to resolve provider issues.
- Develop thorough knowledge of system capabilities related to Facets setup, Facets Business Support, other supporting systems.
- Exercise independent judgment and communicate effectively between internal and external team members.
- Meet department and company performance and attendance expectations.
- Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
- Maintain clear understanding of system set-up and reporting requirements/limitations as required by contractual obligations.
- Participate in provider specific and public presentations as required.
- Assist in leading, shaping and developing special projects related to PacificSource initiatives.
- Perform other duties as assigned.
- Work Experience: Minimum of 5 years’ experience in the health insurance industry, provider organization or associated field related to partnership building. A thorough understanding of services and processes, administrative procedures, government compliance, and the health insurance industry is required. Demonstrated experience in several of the following areas: managing complex projects, ability to develop and execute strategy, ability to understand provider contracts and impacts, process improvement, data analysis and reporting. Demonstrated skills to facilitate, implement, and measure improvement projects strongly desired.
- Education, Certificates, Licenses: BA or BS in business, health care administration, finance, or equivalent work experience desired. Experience in Project Management preferred. Knowledge: Knowledge of coding methodologies required. General understanding of financial arrangements and quality programs across health care products. A thorough understanding of products, contracts, administrative procedures, and the health insurance industry's legal and mandatory guidelines preferred. Ability to remain current on PacificSource administrative procedures and products, healthcare, and the health insurance industry.
- Excellent communication skills, both verbal and written. Ability to communicate effectively with all types of individuals. Excellent public relations skills and public speaking ability. Ability to effectively explain plans and administration to groups of varying educational backgrounds and familiarity with benefits. Ability to effectively communicate with various internal departments. Ability to provide prompt, professional, and courteous service to customers, producers, and PacificSource employees. Ability to work in a fast‑paced environment, managing shifting priorities and multiple tasks simultaneously. Superior work leadership skills, including taking action without specific direction. Requires a high level of integrity and trust, given frequent exposure to confidential material. Demonstrated ability to remain resilient, flexible, and focused in a changing environment. Work autonomously and independently. Desire to learn new things, anticipate problems, and develop contingency plans to manage them.
- Proficiencies: Proficient in Microsoft Word, Excel, PowerPoint, and Outlook.
- Competencies: Building Customer Loyalty Building Strategic Work Relationships Contributing to Team Success Planning and Organizing Continuous Improvement Adaptability Building Trust Work Standards Environment.
- Work inside in a general office setting with ergonomically configured equipment.
- Travel is required approximately 25-50% of the time.
- Accountability
- Collaboration
- Communication (written/verbal)
- Flexibility
- Listening (active)
- Organizational skills/Planning and Organization
- Problem Solving
- Teamwork
The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.
Base Range: $65,296.83 - $111,004.62
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for customer service.
- We practice open communication at all levels of the company to foster individual, team and company growth.
- We actively participate in efforts to improve our many communities-internally and externally.
- We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
- We encourage creativity, innovation, and the pursuit of excellence.
- Stoop and bend.
- Sit and/or stand for extended periods of time while performing core job functions.
- Repetitive motions to include typing, sorting and filing.
- Light lifting and carrying of files and business materials.
- Ability to read and comprehend both written and spoken English.
- Communicate clearly and effectively.
This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT‑WILL at all times.
Founded in 1933, we’re an independent, not‑for‑profit organization that puts our members, and their communities first—across Idaho, Oregon, Montana, and Washington. It's our employees who make it happen: promoting health equity and partnering with providers to deliver better access to optimal, affordable care. So yes, with PacificSource, you get to do great things.
In our effort to put members first—more than 525,000 of them—initiative, commitment, and hard work are supported and rewarded with excellent benefits, competitive wages, and opportunities for personal growth and advancement.
- Flexible telecommute policy
- Medical, vision, and dental insurance
- Incentive program
- Paid time off and holidays
- 401(k) plan
- Volunteer opportunities
- Tuition reimbursement and training
- Life insurance
- Options such as a flexible spending account
PacificSource is an equal opportunity employer and a company that loves helping people. We work with our employees to understand their goals, and provide training, individual development, and career advancement opportunities to help them achieve just that.
Stay tuned! More to come soon!
If you have questions about working at PacificSource or need help with your application, please email HRrecruiting@PacificSource.com.
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