Medicare Provider Engagement Consultant
Cambia Health

Job Info

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MEDICARE PROVIDER ENGAGEMENT CONSULTANT (HEALTHCARE)

Telecommute Option - Must reside in Oregon or Washington

Some Travel Required


WHO WE NEED

The Medicare Provider Engagement Consultant engages providers on Medicare Advantage, providing strategic leadership, and decision-making support to Network Management and business unit leaders with a specific focus on Medicare provider partnerships and objectives. Responsible for several key provider engagements to drive the success of those engagements in Medicare Advantage, including membership growth and the cost, quality, and member experience.
Medicare Provider Engagement Consultant will work across Network Management and Cambia to bring a cross-functional team together to drive success on Medicare objectives and will be a consistent point of contact for the provider across all aspects of the relationship related to Medicare Advantage.
Medicare Provider Engagement Consultant is responsible for the successful execution of short, medium, and long-term Medicare objectives that require provider engagement and collaboration.


Preferred Key Experience:

• Familiarity with Medicare Advantage and its business model
• Experience at a provider organization in population health
• Familiarity w/ Medicare Stars, value-based care, and risk adjustment

Normally to be proficient in the competencies listed below:

Medicare Provider Engagement Consultant would have:

• Bachelor's degree (Master's preferred) in Business Administration, Healthcare Administration or related field
  
• 8 years relevant experience in a large healthcare delivery, health insurance or health care consulting organization with specific experience building provider partnerships and/or value-based agreements
  
• Or equivalent combination of education and experience.
  

YOUR ROLE:

• Develops, coordinates, and drives strategic direction for assigned provider groups related to Medicare Advantage objectives
  
• Acts as primary point of contact for assigned key provider groups for Medicare objectives in partnership with market provider relations teams
  
• Executes engagement strategies related to Medicare objectives such as Medicare Stars, risk adjustment, and clinical initiatives
  
• Leads cross-functional team within Cambia to achieve desired provider outcomes including performance on quality, utilization, and member experience targets.
  
• Works with key leaders within the provider organization to engage with and drive providers toward successful performance of Medicare objectives.
  
• Responsible for being subject matter expert on Medicare with provider partners
  
• Assists senior leadership with special projects related to advancing Cambia's value based and innovative provider relationships.
  

WHAT YOU BRING:

• Deep knowledge of health insurance industry trends, including exposure to integrated finance and delivery models and evolving accountable care and payment models.
  
• Healthcare experience with both provider and payor organizations - preferably with an integrated finance and delivery model.
  
• Proven ability to solve for multiple internal and external stakeholders and work across highly matrixed organizations.
  
• Executive presence, leadership and influence skills, and experience helping complex organizations effect change to improve their operating and strategic position.
  
• Proven business acumen including understanding of market dynamics, strategic planning, financial/budget management, data analysis and decision making.
  
• Demonstrated competency related to supporting complex business initiatives and strategies and driving results across internal teams and/or external partners.
  
• Strong consulting, communication (written and verbal), influencing, and facilitation skills at all levels of the organization.
  
• Proficiency in using Microsoft Office tools and proven ability to display analytical data and research findings for effective presentations and improved decision making.
  
• Demonstrated ability to see the big picture and think strategically about business problems in new ways and the ability to clarify key issues in complex situations.
  
• Excellent written and verbal communication skills.
  
• A proven team player with the ability to partner, maintain and develop relationships.
  

The expected target hiring range for this position is $109k - $129k depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 15%. The current full salary range for the Supervisor Membership is $103k Low Range / $129k MRP / $168k High Range,.

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.

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