Provider Engagement Director
Provider Engagement Director
Oregon
Primary Job Purpose
The Provider Engagement Director provides engagement management, strategic leadership, and decision-making support to Network Management and business unit leaders with a specific focus on innovative provider partnerships and accountable health relationships. Responsible for several key provider engagements to drive the success of those engagements, including membership growth and the cost, quality, and consumer experience of our members touched through the engagement. Will work across Cambia to bring a cross-functional team together to drive successful provider engagements and will be a consistent point of contact for the provider across all aspects of the relationship. Responsible for supporting the successful execution of short, medium, and long-term Cambia business objectives that require innovative provider collaboration.
General Functions and Outcomes
Develops, coordinates, and drives strategic direction and acts as primary senior point of contact for assigned key provider engagements across all lines of business (e.g. Commercial, ASO, FEP, Medicare).
Leads cross-functional team within Cambia to achieve desired provider engagement outcomes, to include membership growth and meeting/exceeding cost, quality, and consumer experience targets.
Works with key leaders within the provider organization to engage with and drive successful performance of the provider engagement.
Leads complex projects related to due diligence, finance, IT, contracting, etc. to support the development, launch, and sustainment of key provider engagements.
Assists senior leadership with special projects related to advancing Cambia's value based and innovative provider relationships.
Leads negotiations and executes contracts as necessary to support provider engagement and assigned objectives.
Minimum Requirements
Deep knowledge of health insurance industry trends, including exposure to integrated finance and delivery models and evolving accountable care and payment models.
Healthcare experience with both provider and payor organizations - preferably with an integrated finance and delivery model.
Proven ability to solve for multiple internal and external stakeholders and work across highly matrixed organizations.
Executive presence, leadership and influence skills, and experience helping complex organizations effect change to improve their operating and strategic position.
Proven business acumen including understanding of market dynamics, strategic planning, financial/budget management, data analysis and decision making.
Demonstrated competency related to supporting complex business initiatives and strategies and driving results across internal teams and/or external partners.
Strong consulting, communication (written and verbal), influencing, and facilitation skills at all levels of the organization.
Proficiency in using Microsoft Office tools and proven ability to display analytical data and research findings for effective presentations and improved decision making.
Experience in new product development and consultative selling a plus.
Normally to be proficient in the competencies listed above:
Provider Engagement Director would have a bachelor's degree (Master's preferred) in Business Administration, Healthcare Administration or related field and 12 years relevant experience in a large healthcare delivery, health insurance or health care consulting organization with specific experience building provider partnerships and/or value-based agreements or equivalent combination of education and experience.
Work Environment
May be required to work outside normal hours
Travel may be required, typically in Oregon
Estimated Salary: $20 to $28 per hour based on qualifications.
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