Provider Relations Executive: Partnerships & Contracting

Blue Cross and Blue Shield of Kansas City; Missouri; On-site; USD 85,000 - 120,000; Full time

Benefits offered by this job

401(k)

Paid time off

Tuition reimbursement

Parental leave

Volunteer time off

Employee discount

Professional development

Job summary

Blue Cross and Blue Shield of Kansas City seeks a Provider Account Executive to coordinate and integrate with provider partners as the quarterback of BlueKC Partnership Teams. The role focuses on provider analytics, payments, demographics, contracting and medical management, with work centered in the Kansas City metro area.

You will build durable physician/hospital relationships, drive quality care, cost containment and issue resolution while collaborating with internal teams to address provider

Qualifications

• Bachelor’s degree in Business, Health Care or related field required.
• 5 years of provider relations experience with proven success.
• 5 years of experience with claims coding, ICD and CPT.
• 5 years of experience with health insurance plans, preferred Provider Relations.
• Strong verbal and written communication and presentation skills.
• Proficient in Microsoft Office.

Responsibilities

• Build and maintain positive physician/hospital relationships with focus on quality care, network development and stability.
• Facilitate resolution of escalated or urgent provider issues.
• Liaise with providers on contracting issues; ensure compensation consistency.
• Partner with SMEs to share provider comments and concerns.
• Deliver provider education on directives, policies, programs and business needs.
• Lead in-person provider visits; create agenda, capture actions and follow up.
• Collaborate with internal partners to deliver provider value-added solutions.
• Identify trends/outliers, determine root causes, summarize clearly.
• Present performance data to providers and discuss improvement opportunities.

Skills

Communication

Presentation

Collaboration

Time management

Education

Bachelor’s degree in Business, Health Care or related field

Tools

Microsoft Office

Claims systems

Job description

Blue Cross and Blue Shield of Kansas City seeks a Provider Account Executive to coordinate and integrate with provider partners as the quarterback of BlueKC Partnership Teams. The role focuses on provider analytics, payments, demographics, contracting and medical management, with work centered in the Kansas City metro area.

You will build durable physician/hospital relationships, drive quality care, cost containment and issue resolution while collaborating with internal teams to address provider