Premera Blue Cross Provider Network Associate II in Spokane, 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* Provider Network Associatefor our *Ancillary Provider Contracting team, you will work in a fast-paced environment that is both challenging and rewarding.. The medical service providers you will be working with are non-hospital/non-physician providers which may include rehabilitation care, skilled nursing, dialysis and labs. You will use your research skills to support the resolution of claims and other contract issues. For the person who likes to learn and have multiple things going on at once, this is an excellent opportunity! You will learn about a variety of provider types, and participate in project work. Our Provider Network Associates are the most knowledgeable resource for resolving provider issues. Your work will help us to insure that we provide high quality and reasonable cost to our network of providers which results in savings to our members.
What you’ll do:
- Build and maintain a positive physician / provider account relationship that fosters a collaborative approach to quality care, network stability and cost containment
- Provide account service, education and contract maintenance of core provider networks of assigned accounts on Premera’s internal and industry resources
- Develop and maintain effective provider networks and monitor the performance of those networks
- Implement standard provider contracts, manage standard contract renewal discussions and negotiations for assigned accounts
- Assist Provider Network Executive on negotiation of custom contracts for a core provider account
- Participate in various projects andcorporate initiatives to develop and implement value added services
- Coordinate small team efforts within and across departments to research and resolve provider issues
What you’ll bring:
- Bachelor's degree or four (4) years’ work experience
- Three (3) years’ experience in an integrated healthcare delivery system environment or working directly with providers
- Project management experience (preferred)
- Experience making presentations
- Self-starter with strong analytical and problem solving skills
- Knowledge of:
- Regulatory issues; such as HIPAA, NCQA
- Network development and provider/vendor network management
- Provider community and market anomalies and/or experience with provider relations is highly desired
- Ability to:
- Negotiate and review standard provider contracts required
- Analyze data, identify trends, and make recommendations for contract issue resolution
- Develop and execute strategy
- Work under pressure with limited resources, competing priorities and to manage to specific project timelines
- Experience with the MSFT Suite – particularly Excel PowerPoint
Premera is proud to offer a comprehensive benefits package including:
- 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
Work is performed within a normal office environment with ambient temperatures.
Ability to travel.
Physical Requirements: The following have been identified as essential physical requirements of this job and must be performed with or without an accommodation:
This is primarily a sedentary role which requires the ability to exert up to 10 lbs. of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. This role requires the ability to keyboard and to communicate clearly and understandably in person, and over the telephone.
Job Title: Provider Network Associate II
Job ID: 11528
Location: Spokane or Mountlake Terrace
Full/Part Time: Full-Time
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, national origin, gender or gender identity, sexual orientation, age, genetic information, disability or veteran status. All staff of Premera and its subsidiary companies must demonstrate the legal right to work in the United States. Premera is an E-Verify employer.