Regence Blueshield Of Idaho Director Provider Contracting - R-4602-4185

at Cambia Health Solutions in Boise, Idaho, United States

Job Description Regence BlueShieldof Idaho Director Provider Contracting
Boise, Idaho or Teleflex in Idaho
Primary Job Purpose
The Director Provider Contracting leads the provider network strategy and contracting team for a large state or across multiple states. Directs the implementation of the network strategy through contracting, negotiation, and administration of provider and facility agreements for physicians, physician groups, healthcare institutions and ancillary services. Cultivates and maintains relationships with key providers and promotes innovative products and reimbursement methodologies.
General Functions and Outcomes

• Leads state-wide or multi-state contracting strategy efforts and partners with leaders across the organization to ensure alignment with broader business strategies and key initiatives.
  
• Leads multi-state contracting and reimbursement strategy efforts for free standing Behavioral Health (BH) facilities.
  
• Collaborates with market contracting teams to effectively support the Standard Professional fee schedule contracting efforts for Behavioral Health professionals.
  
• Leads and coordinates with market contracting team on the overall Mental Health parity for the company.
  
• Ensures contracting staff develops strong partnerships across the provider community and promotes positive working relationships with all types of Cambia providers including physicians, physician groups, ancillary specialty providers, hospitals, institutions, etc.
  
• Collaborates with the Actuarial Team to ensure analytical resources effectively support contracting efforts and pricing considerations. Ensures provider feedback, competitive information, health care delivery trends and other metrics are incorporated into contracting strategies and financial models.
  
• Manages the contracting team including hiring, performance management, development and retention.
  
• Develops strategies along with Vice President of Network Management to ensure unit cost targets and cost stewardship goals are met. Regularly communicates organizational objectives and team goals. Monitors results and metrics to ensure individual and team deliverables are met.
  
• Directs execution of contracting and reimbursement strategy and ensures contractual methodology is in accordance with organization objectives, legal, and regulatory requirements.
  
• May manage related functions, strategic initiatives, and/or best practice development.
  
• Provides support (within and outside the organization) when the VP of Network Management is unavailable.
  

Minimum Requirements

• Demonstrated success in negotiating contracts and managing relationships with large, complex hospitals, provider groups, and integrated delivery systems.
  
• Strong understanding of managed care and accountable health systems models and relationships to contracting strategy and reimbursement methodology.
  
• Analytical expertise and ability to interpret complex data for effective decision making. Includes understanding and competency related to health care funding mechanisms, quality and utilization data.
  
• Strong communication and facilitation skills with all levels of leadership, including the ability to identify and resolve issues and build consensus among groups of diverse stakeholders.
  
• Ability to develop and lead a team including: hiring, goal setting, coaching and development.
  
• Demonstrated competency in resource and project management: budgeting, organizing work, providing leadership to staff, establishing measures for success, and managing to deliverables.
  
• Ability to work in high-pressure circumstances and effectively manage conflict and ambiguity.
  

Normally to be proficient in the competencies listed above:
Director Provider Contracting would have a Bachelor's Degree in healthcare, business or a related field (Masters preferred), 10 years' experience in healthcare Provider Contracting, 3 years leading others, or equivalent combination of education and experience.
FTEs Supervised
5-10
Work Environment

• Boise is the preferred location but qualified candidates in Idaho will also be considered.
  
• Telecommute, Teleflex, or onsite based on location.
  
• Travel may be required, either locally or out of state.
  
• Must be able to provide own transportation.
  

The expected hiring range for a Director Provider Contracting is $142,500 - 165,500 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 25%. The current full salary range for this role is $134,000 - $218,500.
Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:

• medical, dental, and vision coverage for employees and their eligible family members
  
• annual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)
  
• paid time off varying by role and tenure in addition to 10 company holidays
  
• up to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)
  
• up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)
  
• one-time furniture and equipment allowance for employees working from home
  
• up to $225 in Amazon gift cards for participating in various well-being activities. for a complete list see our External Total Rewards page.
  

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and 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.
If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site. To view full details and how to apply, please login or create a Job Seeker account