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
• Ability 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 at Cambia

• 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.

Benefits In exchange for helping members live healthy lives, we offer benefits that empower you to do the same. Just a few highlights include:

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.

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.