Provider Network Executive
Regence - Salt Lake City, UT

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DESCRIPTION

Better care is in the details. Regence needs your inquisitive nature, big-picture viewpoint and strong ties to the medical community. Use your skills to coordinate with multiple providers and facilities to ensure our members get effective, integrated care.

Provider Network Executive
Salt Lake City, UT

Bring your negotiation skills to this role where you will:
  • Responsible for contracting relationships with physicians, physician groups, institutions and ancillary providers including the development of contracting strategies, coordination of analytical support, negotiation, and effective administration for all Regence BlueShield and Regence Care product lines
  • Cultivate and maintain relationships with key providers
  • Negotiate contracts, prepare analysis, recommend strategies, research problem issues and serve as a "client manager"
QUALIFICATIONS

Key qualifications and experience:
  • 5 years in the health care industry in a provider contracting or analytical capacity
  • Manage and analyze performance data- analytics experience preferred
  • Must understand all aspects of managed care, including institutional and professional contracting, as it relates to commercial, Medicaid and Medicare lines of business
  • Command of all aspects of managed care and accountable health systems models and be capable of incorporating into contracting strategy and reimbursement methodology
  • Must be able to build positive relationships and negotiate successfully with institutional and professional providers
  • Must possess a command of varying payment methodologies: such as Pay for Quality / Performance, APDRG, APRDRG, APC, Capitation, Fee For Service, RBRVS, Per Diem, Per Case, Percent of Charges. Etc.
  • Analyze funding and utilization data and provider financial reports, summarize findings and make recommendations
  • Lead contracting projects that include multiple deliverables and participants to the desired outcome.
  • Command of PC word processing and spreadsheet software such as Microsoft Work, Excel, PowerPoint and Access
  • Work in high-pressure circumstances with little or no supervision
  • Master's Degree in Business Administration, Accounting, Finance or Health Care field or equivalent education and experience
Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. To search and apply for employment opportunities at Regence, visit us at www.cambiahealth.com/careers and Apply Online to Job 20188

Hard work and dedication are rewarded at Cambia. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. Drug Screening and Background Check is required.

Regence - 2 years ago - save job - block
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