Provider Network Specialist jobs in North Dakota

All about us

You likely know us as an insurance company, but that’s just a portion of what we do. Hundreds of thousands of North Dakotans trust us to provide them with personalized service and unmatched access to care. It’s a mission we take seriously.

We also work with entities throughout the state to challenge the cost and complexity of health care in North Dakota. This uncompromising goal requires caring, innovative people who are ready and willing to help create a new level of health and well-being in North Dakota and beyond.

Work environment

This opportunity is eligible for an in-office work arrangement based out of our Fargo, ND office, with flexibility to work remotely 1-2 days/week. We empower our employees to find a work style that is best for them. Learn more at Life at Blue | BCBSND.

This position is eligible for internal and external applications. 

Pay information

• Opportunities for continued salary growth through performance-based incentive programs.
• FLSA Category: Exempt-Salaried
• Pay Level: C

A day in the life

The VP of Provider Network Strategy is responsible for providing leadership, direction and guidance to the provider contracting,  provider network performance and provider operations teams within the division. This position is accountable for the development of strategic provider networks including development of new strategic partnering relationships through fee-for-service and value-based contracts, supported by provider reimbursement methodologies and network strategies that improve overall health care affordability, access, quality, and experiences for our members.  This is supported through coordination across the organization and in interaction with providers to plan and implement network development activities and resources to meet corporate business goals.

Your responsibilities will include

• Directs, leads and oversees staff in accomplishing work objectives within the unit(s). Coaches, motivates, rewards and recognizes subordinates. Sets clear goals, objectives and performance expectations and holds employees accountable for achieving results.
• Delivers collaborative strategic leadership within the division in setting long and short-term goals.
• Oversees development, implementation, and leadership for areas of responsibility to ensure the organization delivers affordable, value-based medical and pharmacy products to customers and achieves the most competitive and effective health networks in each market segment.
• Oversees the provider contracting function to achieve strategic contracting goals with providers, including core participation agreements in fee for service reimbursement methodologies and value-based agreements in fee for value reimbursement methodologies for all lines of business.
• Collaborates within the organization to drive development of reimbursement methods and quality programs that shape behavior and performance of provider networks for the benefit of our member population and customer groups.
• Oversees the development and management of provider networks, including provider performance based network strategies to improve overall health care affordability and member experience, and the planning and implementation of provider network activities and resources through provider data analytics, financial analyses, competitive intelligence, market research, population health informatics and medical cost trend analyses.
• Fosters effective leadership to achieve the best customer experience possible for members, providers, staff, employer groups, the Association, and other constituents, as well as promoting and furthering corporate goals relative to areas of responsibility.
• Partners with and educates regulators, politicians, board members, policymakers, associations, state officials, community leaders, providers and various influential representatives of the healthcare community on the merits and effects of healthcare policy and practice.

What you need to succeed

• A Bachelor's degree in Business, Healthcare, Finance, or related.
• 10 years of healthcare, insurance industry or related experience with a deep understanding of the provider landscape.
• 7 years of supervisory/staff leadership experience with a proven ability to provide strategic leadership to a director-level team.
• Ability to provide direction and execute on divisional initiatives tied to provider performance and contracting.
• Comfortable presenting material to executive leadership, as well as other audiences across the organization.
• Desire to learn the business and cross-collaborate with internal teams and our provider groups.
• Advanced communication and interpersonal skills, navigating the work with resilience and tenacity. 

Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

Benefits and perks

• Wellness incentives including well-being lifestyle spending accounts, employee assistance program and employee discounts.
• Encouraged paid time off including paid holidays and flexible holidays to use as you wish.
• 16 hours of paid volunteer time with a $200 donation to a charity of your choice upon completion of all volunteer hours.
• Employee recognition, community initiative events and yearly company outings.
• Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments.
• Our core benefits include health, dental, vision and life insurance, short-term and long-term disability and paid parental leave.

Equal opportunity employment

Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity.

For questions, please email careers@bcbsnd.com.

This job posting will be closed on 6/7/2024 at 8:00 a.m. (CT). No further applications will be considered.