Program Director, Provider Performance

Program Director, Provider Performance 

Oregon, Washington, Idaho or Utah 

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable

health care system.  

Who We Are Looking For: 

Every day, Cambia’s dedicated team is living our mission to make health care easier and lives better. As a member of the Network Innovations team, our Program Director, Provider Performance is accountable for planning, prioritization, implementation, and management of Cambia’s provider performance framework project and related initiatives – all in service of making our members’ health journeys easier.

Are you passionate about provider performance? Do you thrive working with cross functional teams? Then this role may be the perfect fit. 

What You Bring to Cambia: 

Qualifications:  

• The Program Director would have a bachelor’s degree in business or health administration (Master’s preferred) or related field
• 10+ years of experience in program management or equivalent combination of education and experience. 
• Experience driving transformation in programmatic innovation, alternative payment model development, network & product strategy, and strategic implementation are all desired. 
• Prior experience in implementation and management of provider evaluation methodologies/programs with either payers or provider organizations also preferred.

Skills and Attributes: 

• Demonstrated ability to develop, manage, and sustain cross functional relationships internally and externally
• Knowledge of health plan network dynamics, alternative payment models, and forward-thinking healthcare trends
• Conducts business with high regard for Cambia's corporate values and in compliance with its Code of Business Conduct.
• Performs other duties and responsibilities as assigned.
• Experience in the area of project coordination and management.
• Excellent verbal and written communication skills.  Ability to communicate effectively, both orally and in writing, with individuals and groups, regarding complex issues and initiatives.
• Ability to adapt quickly to changing market conditions, enterprise needs, and technical advancements.

What You Will Do at Cambia:  

• Planning and Prioritization: Accountable for planning, prioritization, implementation, and management of Cambia’s provider performance framework project and related initiatives internally and externally to achieve enterprise success criteria.  The provider performance framework is Cambia’s methodology to evaluate health care providers across quality, appropriateness of care, and cost efficiency and will be used enterprise wide to help guide Cambia members to high value care.
• Stakeholder Engagement: Work closely with cross-functional teams, including Network Management, Actuarial, Digital, Product, and other business stakeholders. Liaise with matrixed support to ensure high-functioning program implementation and operations.
• Process Governance and Management: Continually evolve and optimize the workflows required for operational excellence across the project internally and externally; create, document, and socialize program governance and best practices, including training materials and education.
• External Collaboration and Partnerships: Build, cultivate, and leverage strong partnership with vendor for ongoing reliability and joint development.
• Effective Communication: Create and maintain effective executive reporting to represent overall project health, mitigate risk, and inform strategic decisions. Own documentation and dissemination of product releases, new capabilities, training, education, and process documentation.
• Support Network Innovations: Support Network Innovations programs team in initiatives to impact quality and cost stewardship of our members
• Thought Leadership: Provides thought leadership, systems thinking, design thinking and industry expertise to the development of strategic programs, horizontally integrating with innovation and operations across the organization.

The expected hiring range for the Program Director, Provider Performance is $120,700 - $163,300 depending on skills, experience, education, and training; relevant licensure / certifications; and performance history. The bonus target for this position is 15%.  The current full salary range for this role is $113,000 - $185,000. #LI-remote