Salary
💰 $131,500 - $303,195 per year
About the role
- Oversees key Network Management contracting activities, including negotiating fee schedules, reimbursement rates, and contract terms and conditions.
- Controls the development and expansion of the company's provider network by evaluating potential network providers, negotiating contracts, and establishing relationships with healthcare providers to ensure a comprehensive and high-quality network.
- Contributes to optimizing the network's performance and effectiveness by analyzing network data, utilization patterns, and market trends to identify opportunities for network enhancements, cost savings, and improved access to care.
- Manages the performance of network providers, including tracking key performance indicators, analyzing provider performance data, and implementing performance improvement initiatives.
- Conducts market analysis, assesses competitive landscapes, and makes recommendations for network expansion strategies.
- Communicates findings to executive leadership and stakeholders, identifying opportunities for improvement and cost containment.
- Manages operational aspects of the team, subsequently implementing workforce and succession plans to meet business goals and objectives.
- Guides management for individual performance evaluations aimed to provide critical feedback for skills development and depth of work area experience.
Requirements
- 10+ years of experience in managed care; leading and managing teams.
- Experience contracting with providers and hospital systems.
- Strong analytical skills including root cause analysis.
- Ability to think strategically.
- Skilled at collaborating and working across a matrixed organization.
- Expertise in market level management, cost drivers and levers, and knowledge of economic, regulatory and marketplace issues.
- Possess exceptional leadership skills and transformational experience with a proven track record of delivering results.
- Education Bachelor's Degree required.