VP Network Management
The VP of Provider Network Management provides executive leadership and direction to the Provider Services organization for a state-wide market. You will participate in the development and execution of holistic provider strategies (including fee for service contracting, value-based arrangements, Cost Stewardship, etc.) that support both Regence-wide and state-specific objectives. Additionally, you will develop and maintain key strategic relationships and partnerships with providers across the state in service to key business objectives. The VP ensures there is appropriate provider network breadth and stability to support product and enrollment objectives. You will also oversee contract negotiations and provider relations and serve as a key leader in the market alongside the Market President, VP of Sales, and Executive Medical Director, both within the community as well as with the local market team.
At Cambia, our values are fundamental to achieving our Cause of transforming the health care industry. They guide our actions and bring diverse perspectives together to improve the health care journey for those we serve. All eight values are equally important and linked to the others: Empathy, Hope, Courage, Trust, Commitment, Innovation, and Accountability. These values are not just words on paper - we live them every day.
Achieving our ambitious Cause requires exemplary leadership. In addition to the Cambia values listed above, our leaders demonstrate the following leadership attributes: Cambia leaders think big, push boundaries, envision possibilities, inspire and empower others. They build collaborative relationships beyond their functional area and create workplaces which are just and transparent. Our leaders must be lifelong learners, develop others and act as role models for their teams, colleagues, external partners and—most importantly—our current and future members.
Responsibilities & Requirements
- Partners with Regence-wide and market-based leadership teams to develop and execute short and long-range plans, goals, and objectives related to network strategy, provider satisfaction and cost. Ensures networks support goals regarding affordability, geographic coverage, marketability and satisfaction.
- Develops and oversees effective local market contracting strategies and execution including forecasting expenditures, managing to budget targets, and regulatory compliance.
- Ensures productive relationships between Regence and delivery system leadership. Monitors provider related metrics and satisfaction results and leads the development of interventions to continually improve.
- Oversees communication to providers in order to build effective partnerships and ensure compliance with contractual provisions and regulatory requirements.
- Provides an executive presence within the market as needed to support other relationships such as those with purchasers, brokers, agents and consultants.
- Determines appropriate resource needs, creates and manages department and/or project budget, allocates resources, and approves expenditures.
- Manages the Provider Services organization through fostering an effective work environment and ensuring employees receive appropriate communication, recognition, and development. Participates in organizational talent management and succession planning.
- Supervises 3 direct reports with 8-10 total team members.
- VP Network Management would have a/an Bachelor's degree in business or healthcare administration (Masters preferred) and 10 years relevant management experience, including 5 years of negotiating contracts, or equivalent combination of education and experience.
- Demonstrated ability to coach, develop and motivate others, lead high performing teams and manage managers.
- Strong communication and facilitation skills with all levels of the organization and executive-level external partners, including the ability to resolve issues and build consensus among groups of diverse stakeholders.
- Proven ability to build collaborative, strategic relationships with a variety of people and personaltiy types, both inside and outside the comopany. Comfortable working in a matrix environment.
- Demonstrated success in negotiating contracts and managing complex relationships with hospitals, provider groups, and integrated delivery systems that include fee-for-service contracts, strategic value-based arrangements, and other provider partnership initiatives.
- General business acumen including understanding of market dynamics, financial/budget management, data analysis and decision making..
- Strong knowledge of health insurance industry trends, reimbursement methods, and evolving accountable care and payment models.
- Demonstrated competency related to creating and executing business strategies and driving results across internal teams and/or external partners.
Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. 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. 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 drug screen and background check is required.
Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 100 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.
If you’re seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers’ engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.
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Cambia Health Solutions, headquartered in Portland, Oregon, is dedicated to transforming health care. We put people at the heart of everything we do as we work to make the health care system better and more economically sustainable for people and their families. Our company reaches more than 70 [...]