There's never been a time that was more right for people who want to lead. Health care is changing and evolving at a pace that few could have predicted. Technology, ideas and bold vision are taking companies like Company to new levels of performance. This is the time and the opportunity that can bring your impact to a whole new level. We're driving ever higher levels of sophistication in how provider networks are composed and compensated. Your expertise in provider networks can help us build in the next phase of evolution. In this Director level role, you'll use your knowledge and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader.
- Develop, translate and execute strategies or functional/operational objectives including programs that impact markets of customers and consumers
- Direct cross-functional and/or cross-segment teams to develop enterprise-wide Clinically Integrated Networks focused on specific clinical areas/service lines such as oncology or cardiology
- Oversee network analysis and strategy development and implementation
- Drive program design and implementation to improve quality and affordability through improvements in appropriateness and effectiveness
- Ensure teams are obtaining, validating and analyzing data impacting network availability and access
Get ready for some significant challenge. In this position, you'll work closely with value-based contracting, analytics and senior leadership in negotiations as you develop and maintain relationships with hospital and physician groups.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- Undergraduate degree or equivalent work experience
- 8+ years experience working with a managed care organization or health insurer; or as a consultant in a network/contract management role, such as contracting, provider services, etc.
- 6+ years experience in data analysis
- 4+ years experience managing staff
- 3+ years of project management or project lead experience
- 5+ years experience with claims systems
- 3+ years experience with contract submission, validation and maintenance with strong knowledge of business processes that impact facility/ancillary contact loading and auditing
- Proficiency with all facility/ancillary contract reimbursement methodologies