Provider Relations Executive

Locations

• Hybrid
• Salary Range : 59,716.46 USD to 95,546.34 USD
• Professional Administrats
• Full-Time
• Requisition #: PROVI
  005431

All about us

You likely know us as an insurance company, but that’s just a portion of what we do. Hundreds of thousands of North Dakotans trust us to provide them with personalized service and unmatched access to care. It’s a mission we take seriously.

We also work with entities throughout the state to challenge the cost and complexity of health care in North Dakota. This uncompromising goal requires caring, innovative people who are ready and willing to help create a new level of health and well-being in North Dakota and beyond.

Work environment

This opportunity is open to a hybrid in-office working arrangement out of the Fargo, ND office or within a commutable distance of one of our district offices in Bismarck, Minot, or Grand Forks. We empower our employees to find a work style that is best for them. Learn more at Life at Blue | BCBSND.

Pay information

• Individual pay will be based on skills, experience, qualifications, location, internal equity, and other relevant factors.
• Opportunities for continued salary growth through a performance-based merit program.
• The estimated starting salary for this position is 60,000 - 77,000.
• This position is eligible to participate in the company’s annual incentive program.

At BCBSND, we’re committed to providing fair and equitable compensation. While the posted salary range reflects the full compensation range for this role, offers typically fall at or below the midpoint, and in alignment with internal equity and role expectations. Individual offers are based upon candidates’ unique experience, education, and skillsets. The top of the range reflects the ceiling for this role and is only used for offers in exceptionally rare cases.

We do not extend offers above the posted maximum.

The Provider Relations Executive manages the full provider experience for assigned providers, including education, communication, Alternative Payment Models (APMs) performance, vendor integration, and relationship building. Drives healthcare transformation to improve quality, cost, and experience by enabling provider success in Cambia s APMs and innovative initiatives. Manages cross-functional relationships to support effective partnerships and maintain network stability.

• Develops collaborative partnerships with providers and internal stakeholders as a trusted advisor
• Documents provider relationships and tracks performance metrics
• Maintains knowledge of Cambia programs and educates stakeholders
• Facilitates Joint Operating Committees and work groups to improve outcomes
• Drives provider engagement in strategic programs including Medicare Advantage activities
• Identifies initiatives to help providers transition from Fee for Service to innovative payment models
• Manages implementation of cross-functional strategies to improve provider and member experience
• Develops education programs and serves as subject matter expert on provider landscape
• Represents the health plan at external meetings and resolves escalated issues

• Deep understanding of provider community and healthcare delivery systems
• Excellent communication and facilitation skills
• Self-directed with creative critical thinking abilities
• Professional presence and change management knowledge
• Strong consulting and influencing skills at all organizational levels
• Presentation skills for various settings and audiences
• Initiative, prioritization, and deadline management
• Knowledge of provider coding, reimbursement, and APMs
• Understanding of total cost of care factors
• Ability to manage conflict and ambiguity
• Proficiency with Microsoft Office tools
• Ability to travel extensively within state
• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

Normally to be proficient in the competencies listed above:

A Provider Relations…