Premera Blue Cross Senior Provider Network Executive in Mountlake Terrace, Washington

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!

As a Sr. Provider Network Executive (Sr. Account Manager) for the Healthcare Services Provider Network team, you will be accountable for the cultivation and maintenance of the most high profile and significant relationships for Premera in the provider network space. You’ll need to thrive in the spotlight and deliver on stable and predictable strategic outcomes that support the organization more broadly. Reporting directly to the VP of Provider Network Management, you will work with strategic organizations, regionally and nationally to effectively manage and drive positive performance of our organization in terms of membership, quality, customer service, customer engagement and cost. You’ll be working on -value based initiatives, which are competitive with any in the industry. Premera is embracing collective collaboration with provider systems around healthcare transformation and not simply providing network oversight. We are leveraging our strategic partnerships so we can positively impact the way healthcare is delivered. You will rely upon your skill and finesse to appropriately engage our strategic partners in such a way as to push initiatives that support the growth of these partners and of Premera’s membership.

What you’ll do

  • Develop and maintain innovative, value-based relationships with the most multi-faceted and significant healthcare providers/systems, employing innovative payment methodologies and alternate funding arrangements

  • Lead the negotiation and implementation of complex provider contracts and provider engagement involving healthcare transformation

  • Consult on behalf of Premera to foster a collaborative approach to quality care, network stability and cost containment

  • Support and encourage providers in the promotion of understanding of patient engagement, adherence, quality improvement and cost savings program(s)

  • Monitor and analyze financial and quality metrics to assess effectiveness of networks, report findings to leadership, and create action plan

  • Collaborate with Healthcare Economics in rate development and proposal analysis

  • Lead a high-level, cross-functional team to provide operationally excellent service and support to strategic accounts

  • Inform and report to Senior Leadership as necessary

  • Create and deliver provider-specific and public presentations

What you’ll bring

  • Bachelor’s degree or four (4) years of experience in a provider or payer environment.

  • Six (6) years of experience in managing provider relationships in the health care or insurance industry, including six (6) years’ payer or provider contracting experience

  • Four (4) years of experience negotiating complex and multi-faceted contracts

  • Master’s degree preferred

  • Consulting experience with executive leadership regarding provider systems and health plan organizations

  • Working knowledge of HIPAA, NCQA, government health care programs, and risk coding

  • Knowledge of:

  • o Network development and provider/vendor network recruitment o Provider community and market anomalies o Complex and alternate funding arrangements and payment methodologies such as gain-sharing and value-based contracts

  • Strong ability to develop and execute strategy

#LI-MS1

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 careers@premera.com or via phone at 425-918-4785.

At Premera, we make healthcare work better. By focusing on improving our customers’ experience purposefully and serving their needs passionately, we make the process easier, less costly, and more positive. Through empathy and advocacy, we change lives.

As the leading health plan in the Pacific Northwest, we provide comprehensive health benefits and services to more than 2 million customers, from individuals to Fortune 100 companies. Our services include innovative programs focused on health management, wellness, prevention, and patient safety. We deliver these programs through health, life, vision, dental, disability, and other related products and services.

Premera Blue Cross is headquartered in Mountlake Terrace, WA, with operations in Spokane and Anchorage. The company has operated in Washington since 1933 and in Alaska since 1952. With more than 80 years of experience in the region, we deliver innovation, choice, and expertise.