Provider Network Executive III

Join our team to do meaningful work and improve people’s lives. Our purpose—improving customers’ lives by making healthcare work better—drives real change. At Premera, you’ll have the opportunity to grow, innovate, and lead with purpose in a collaborative and supportive environment.

About the Role

The Provider Network Executive III (PNE III) develops and maintains effective relationships with key provider accounts to achieve Premera’s operational and strategic goals. In this highly visible role, you’ll negotiate and manage strategic provider relationships across Washington state, ensuring alignment with Premera’s vision, product development strategies, and broader business objectives.

Responsibilities

• Develop and execute account management and service strategies to meet corporate strategic and financial objectives.
• Serve as the main point of contact for providers, coordinating all Premera interactions with assigned accounts.
• Build and maintain positive relationships with complex provider accounts using consultative skills and industry knowledge.
• Monitor and analyze network performance to ensure quality care, network stability, and cost containment.
• Develop and maintain effective provider networks, including custom and standard networks with complex payment methodologies.
• Lead negotiation and implementation of complex or custom provider contracts, ensuring adherence to rate targets, timelines, and accuracy audits.
• Collaborate with Healthcare Economics on rate development and proposal analysis.
• Establish and lead multi-disciplinary teams to provide operationally excellent service and support to assigned accounts.
• Consult and educate providers and internal stakeholders, creating provider-specific and public presentations.
• Proactively communicate with leadership and stakeholders on account status to align contract outcomes with Premera’s goals.
• Engage providers to promote patient engagement, adherence, cost-saving programs, and preventive care initiatives.
• Perform other duties and projects as assigned.

Requirements

• Bachelor’s degree or four (4) years of experience in a provider or payer environment. (Required)
• Four (4) years of experience in payer or provider contracting and managing provider relationships in the healthcare or insurance industry, including:
  • Two (2) years of experience negotiating contracts. (Required)
• Master’s degree in a related field. (Preferred)
• Project management experience. (Preferred)
• Hospital contract negotiation experience. (Preferred)
• Working knowledge of HIPAA, NCQA, government healthcare programs, and risk coding.
• Knowledge of network development, provider/vendor recruitment, and market anomalies.
• Demonstrated ability to manage complex contract negotiations and develop/execute strategy.
• Strong experience in Provider Relations.
• Independent, self-motivated work style with the ability to lead with minimal direction.
• Excellent verbal and written communication skills, including public presentations, training, and meeting facilitation.
• Strong analytical, problem-solving, and interpersonal skills.
• Proven ability to lead teams addressing complex issues.
• Strong organizational, planning, and administrative skills.
• Ability to work under pressure with tight timelines, limited resources, and competing priorities.

Benefits

Our comprehensive total rewards package supports your health, well-being, and growth with a broad array of benefits:

• Medical, vision, and dental coverage with low employee premiums.
• Voluntary benefits, including pet insurance.
• Life and disability insurance.
• Retirement programs: 401K with employer match and a pension plan vested after 3 years of service.
• Wellness incentives, including mental well-being resources, counseling services, stress management, and mindfulness programs.
• Generous paid time off.
• Tuition assistance for undergraduate and graduate degrees.
• Employee recognition program for anniversaries and team accomplishments.
• Hybrid work model with on-site resources, networking opportunities, and team engagement.
• Commuter perks to reduce environmental impact and costs.
• Free on-site parking and subsidized on-campus cafes.
• On-site fitness and well-being center with in-person and virtual workouts, nutritional counseling, and recreational activities (e.g., shuffleboard, ping pong).
• Engaging on-site activities, including health and wellness events, coffee connects, and disaster preparedness fairs.

Pay

The salary for this role varies based on geographic location, market conditions, and experience. The posted range is $92,400 – $157,100, with a target up to and around the midpoint. This range applies to higher cost-of-labor markets, including Western Washington and Alaska. Compensation will be discussed further during the interview process.