Strategic Provider Relations Lead for VBR

Highmark Health; Camp Hill (Cumberland County); Hybrid; USD 120,000 - 170,000; Full time

Job summary

Highmark Inc. is seeking a senior professional to own and optimize provider relationships within the Highmark Network. You will lead value-based reimbursement initiatives, drive total cost of care reductions, and partner with internal departments to ensure program success and quality compliance (STAR/HEDIS).

The role requires strong stakeholder management, strategic partnership capabilities, and experience in healthcare reimbursement models. Hybrid work options and travel are available as needed.

Qualifications

• 7 years of experience in healthcare / insurance industry.
• 3 years of experience in presenting concepts to varying audiences.
• 3 years of Project management experience or other relevant experience with high accountability for managing multiple tasks with defined deadlines.

Responsibilities

• Lead VBR activities and implementation of new tools for all assigned providers.
• Educate providers on initiatives focused on managing medical expenses and maximizing HEDIS and STAR metrics.
• Coordinate in a matrixed liaison role with contracting, operations, and support areas to ensure initiatives are developed and executed.

Skills

Provider market knowledge

Reimbursement methods

Public speaking

Process improvement

Communication & PM

MS Office

CMS/HIPAA compliance

Education

Bachelor's degree

Tools

PowerPoint

Excel

Word

Job description

Highmark Inc. is seeking a senior professional to own and optimize provider relationships within the Highmark Network. You will lead value-based reimbursement initiatives, drive total cost of care reductions, and partner with internal departments to ensure program success and quality compliance (STAR/HEDIS).

The role requires strong stakeholder management, strategic partnership capabilities, and experience in healthcare reimbursement models. Hybrid work options and travel are available as needed.