Provider Relations Executive

About the role

Hybrid role at our Fargo, Bismarck, Grand Forks, Jamestown or Minot, North Dakota offices. Candidates must reside within commutable distance of that location or be willing to relocate.

Qualifications

• Bachelor's degree in Healthcare Administration or related field and a minimum of 5 years of experience in the healthcare industry with specific focus in provider relations, provider contracting, customer service, financial analysis: Provider/payer strategy development or implementation; Provider/payer contracting and reimbursement, preferably managed care; delivery system administration, or equivalent combination of education and experience.
• Valid driver's license is required.

Skills and attributes

• Deep understanding of the provider community, healthcare delivery systems, coding, reimbursement, and Alternative Payment Models (APMs)
• Excellent communication, facilitation, and presentation skills across diverse audiences and organizational levels
• Strong consulting, influencing, and change management abilities with a professional presence
• Self-directed critical thinker with strong initiative, prioritization, and deadline management skills
• Able to navigate conflict, ambiguity, and total cost of care considerations effectively
• Proficiency with Microsoft Office tools, with experience in AI technologies to enhance productivity and decision-making highly desired

What You Will Do

• Develops and maintains collaborative partnerships with providers and internal stakeholders as a trusted advisor, documenting relationships and tracking performance metrics
• Maintains deep knowledge of Cambia programs and serves as a subject matter expert, educating stakeholders on the provider landscape and innovative payment models
• Facilitates Joint Operating Committees and work groups to drive improved outcomes and provider engagement in strategic programs, including Medicare Advantage activities
• Identifies and supports initiatives to transition providers from Fee-for-Service to value-based and innovative payment models
• Manages implementation of cross-functional strategies to enhance provider and member experience
• Develops and delivers education programs tailored to diverse provider and stakeholder audiences
• Represents the health plan at external meetings and resolves escalated issues to maintain network stability and trust

Pay and Benefits

Pay ranges vary based on the candidate's work location. The expected hiring range depends on skills, experience, education, and training; relevant licensure / certifications; and performance history. North Dakota: The expected hiring range is $66,000 - $90,000 and the full salary range is $59,716 - $95,546.

About Cambia: Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused health care. Whether we're helping members, lending a hand to a colleague or volunteering in our communities, our compassion, empathy and team spirit always shine through.

Why Join the Cambia Team? At Cambia, You Can Work alongside diverse teams building cutting-edge solutions to transform health care. Earn a competitive salary and enjoy generous benefits while doing work that changes lives. Grow your career with a company committed to helping you succeed. Give back to your community by participating in Cambia-supported outreach programs. Connect with colleagues who share similar interests and backgrounds through our employee resource groups. We believe a career at Cambia is more than just a paycheck – and your compensation should be too.

We are happy to offer work from home options for most of our roles. To take advantage of this flexible option, we require employees to have a wired internet connection that is not satellite or cellular and internet service with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb. As part of our security requirements, new hires will need access to a personal mobile device to set up Multi-Factor Authentication (MFA) upon joining the company. MFA is an important layer of protection for accessing Cambia systems and is required for all employees.

We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.