Strategic Provider Partnerships Lead | VBR & TCOC Focus

Highmark Health; Wilkes-Barre (Luzerne County); On-site; USD 90,000 - 150,000; Full time

Job summary

Highmark Health in Pennsylvania seeks a senior leader to own provider relationships across large networks, drive value-based reimbursement improvements, and align performance with STAR/HEDIS goals. You will collaborate with internal teams and external partners to optimize costs and outcomes.

The role requires 7+ years in healthcare/insurance, strong communication, project management, and data analytics skills.

Qualifications

• 7 years of experience in healthcare / insurance
• 3 years of experience in presenting concepts to varying audiences
• 3 years of Project management or equivalent high-accountability experience

Responsibilities

• Lead and support value-based reimbursement (VBR) activities and educate providers on initiatives to improve outcomes and reduce costs.
• Manage provider relationships to improve operational efficiencies and communicate policy changes across internal teams and providers.
• Coordinate with contracting, operations and support areas to implement initiatives and resolve provider issues.

Skills

Provider market knowledge

Public speaking

Analytical thinking

Communication & collaboration

Education

Bachelor’s degree in Business, Healthcare related field

Tools

Microsoft PowerPoint

Excel

Word

Job description

Highmark Health in Pennsylvania seeks a senior leader to own provider relationships across large networks, drive value-based reimbursement improvements, and align performance with STAR/HEDIS goals. You will collaborate with internal teams and external partners to optimize costs and outcomes.

The role requires 7+ years in healthcare/insurance, strong communication, project management, and data analytics skills.