Provider Network Exec II (2 openings), Mountlake Terrace, WA
Provider Network Exec II
Mountlake Terrace WA
Join Our Team: Do Meaningful Work and Improve People’s Lives
Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.
To better serve our customers, we’re creating a culture that promotes employee growth, collaborative innovation, and inspired leadership. We are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives!
Who We Are
Our team builds and maintains honest, strong relationships with over 13,000 healthcare providers in Washington and Alaska. We work with a broad range of provider types, including doctors, hospitals, dentists, physical therapists, skilled nursing facilities, and others who care for our customers.
Here's what we do:
- Develop, negotiate, and maintain provider contracts
- Create, manage, track, and report on all provider contracting documents
- File contract documents and monitor for contract compliance with state government agencies
- Answer provider questions that support day-to-day provider operations
- Create self-service tools for providers and focus on paying claims correctly
- Share information and consult with providers on how to improve performance on customer outcomes
The Provider Network Executive II develops and maintains effective relationships with strategic or core provider accounts, generally custom or complex in nature, to achieve Premera’s operational and strategic goals, product development strategies, and continuity of Premera’s vision and values. This position negotiates standard to complex agreements, often with innovative funding arrangements, and manages ongoing provider relationships.
What you'll do
- Develop and execute ongoing account management and service strategy to meet corporate strategic / financial objectives.
- Serve as main point of contact for the provider and coordinate all Premera interactions with assigned provider accounts.
- Build and maintain positive physician/provider relationships, generally with more complex accounts. Utilize consultative skills, industry knowledge, and Premera product knowledge to foster a collaborative approach to quality care, network stability and cost containment. Monitor and analyze network performance.
- Develop and maintain effective provider networks (standard and custom), often with complex payment methodologies. Participate in payment and delivery systems innovation initiatives.
- Lead negotiation and implementation of complex or custom provider contracts.
- Complete negotiations within preplanned rate targets, meet timelines, ensure the established implementation period and perform implementation audits for accuracy of assigned accounts.
- Collaborate with Healthcare Economics in rate development and proposal analysis.
- Establish and lead a multi-disciplinary team to provide operationally excellent service and support to assigned accounts.
- Consult and educate assigned accounts and internal stakeholders, providing industry and cross account expertise. Create provider specific and public presentations.
- Proactively communicate with Provider Strategy & Solutions (PS&S) leadership and internal stakeholders on account status to facilitate proper internal support of account management efforts to ensure that the resulting final contract supports Premera's operational and strategic goals.
- Engage providers to promote the concept and understanding of patient engagement adherence, cost savings preventative programs Other duties and projects as assigned.
What you'll bring
- Bachelor’s degree or four (4) years of experience in a provider or payer environment.
- Four (4) years of experience in payer or provider contracting and managing provider relationships in health care or insurance industry to include:
- Two (2) years of experience negotiating contracts
What we offer
- Medical, vision and dental coverage
- Life and disability insurance
- Retirement programs (401K employer match and pension plan)
- Wellness incentives, onsite services, a discount program and more
- Tuition assistance for undergraduate and graduate degrees
- Generous Paid Time Off to reenergize
- Free parking
Equal employment opportunity/affirmative action:
Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.
If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at firstname.lastname@example.org or via phone at 425-918-4785.