Design, implement, and optimize innovative and value-based payment contracting strategies
Collaborate with multiple functional health plan departments to build out a strategic payment innovation roadmap
Lead implementation of prioritized initiatives in partnership with Provider Network Management, Medical Management, Product, Claims, Sales and Marketing, Finance and Actuarial teams
Lead, coach, train, performance manage a team
Lead the identification, development, work process design and implementation of new network provider innovation models
Research Federal, State and competitor strategies on value-based payments
Develops and implements provider network innovation and optimization standards and guidelines to increase market share, revenue growth, and quality outcomes
Develops, implements and maintains a multi-year strategic roadmap for the health plan's value-based payments strategy
Leads a cross-functional team and work across the health plan to implement targeted initiatives (bundled payments, hospital quality incentives, shared risk redesign)
Collaborates with Networks team on payment innovation work

Requirements

Bachelors’ degree in a related field or equivalent experience
Master’s degree preferred
7+ years of contracting, network development, or provider network strategy or analysis experience in a healthcare or managed care environment
Experience in developing and executing multiyear roadmaps, evaluating various value based programs
Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff
Project/Program management experience.
PMP Certification preferred.

Benefits

competitive pay
health insurance
401K and stock purchase plans
tuition reimbursement
paid time off plus holidays
flexible approach to work with remote, hybrid, field or office work schedules

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills

payment contracting strategiesvalue-based paymentsnetwork provider innovation modelsstrategic roadmap developmentproject managementprogram managementperformance managementwork process designmultiyear roadmap executioncontracting analysis

Soft skills

leadershipcoachingtrainingcollaborationcommunicationstrategic thinkingteam managementperformance managementproblem-solvinginterpersonal skills

Certifications

PMP Certification