Associate Director, Provider Network Contracting

Primary Responsibilities

• Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management
• Apply network configuration and incentive-based payment models as appropriate to improve quality and efficiency
• Identify and resolve technical, operational and organizational problems
• Direct work that impacts entire functions and/or customer accounts (internal or external)

Required Qualifications

• 5+ years of supervisory level experience in a network management-related role handling complex network providers with accountability for business results
• 5+ years of experience with provider contracting
• 2+ years of experience developing product pricing and utilizing financial modeling in making rate decisions
• 2+ years of experience managing a medical cost and administrative budget
• Expert level of knowledge of Medicare Resource Based Relative Value System (RBRVS), DRGs, Ambulatory Surgery Center Groupers, etc.