SVP, National Provider Contracting & Network Development

Directly accountable for provider contracting across Kaiser Foundation Health Plan and Hospitals (KFHP/H) in partnership with national functions and market leadership. Advances an integrated, nationally aligned integrated care and coverage strategy while supporting the unique needs of local markets.

Responsibilities

• Oversees, aligns, and coordinates enterprise provider strategy development to meet KFHP/H organizational objectives by leveraging best practices, reducing unwarranted variation, and capitalizing on Kaiser Permanente’s scale.
• Partners with market leadership to ensure each region has a provider strategy that meets long- and short-term market needs.
• Engages with Business Development on strategic provider relationships affecting multiple regions.
• Leads development of a multi-year roadmap to achieve common standards across key provider contracting agreements, including:
  • Conducting program-wide analysis to identify best practices and terms.
  • Creating a national model for agreements with common components across all regions.
  • Employing best-in-class provider compensation and incentive strategies aligned with regional business strategies and compliance requirements.
  • Championing and codifying a holistic integrated program across the care delivery continuum to achieve desired performance.
  • Supporting regions in developing multi-year approaches to meet common standards and increase alignment.
• Engages with regional leaders to align national provider contracting initiatives with organizational strategic initiatives.
• Oversees creation of routine management reporting capability, in collaboration with National Finance and Integrated Care & Coverage, to inform leadership on network performance (access, service, quality, and cost).
• Monitors and evaluates network performance, identifying opportunities for improvement and leading corrective actions in partnership with national and market leaders.
• Oversees development of standardized data, reporting, and best practices to support regional provider contracting teams, including:
  • Providing relevant market data, external benchmarking, and budgeting support.
  • Ensuring consistent and appropriate data collection and reporting processes across all regions.
  • Developing standard tools and templates for contracts and electronic approval processes.
• Leads enterprise contracting technology strategy, including selection, deployment, and adoption of common systems, tools, and platforms for consistent contracting and provider relationship management across markets.
• Oversees development and implementation of systems and tools supporting effective administration of agreements across regions, including:
  • Policies and guidelines for oversight practices.
  • Reporting to enable effective monitoring of key controls and adherence to agreement details.
  • Independent reviews to validate data and other agreement deliverables.
• Establishes and advances provider relations strategies to strengthen partnerships, improve provider experience, support issue resolution, and enable effective implementation of enterprise contracting objectives.
• Manages vendor and direct contract relationships for KPIC, including PPO and pricing vendors, maximizing contract performance and aligning processes with KPIC operational requirements.
• Increases knowledge base and competency in developing highly effective provider agreements through a Provider Contracting Community of Practice, including:
  • Conducting training and disseminating information on key topics and initiatives.
  • Identifying areas of common interest across markets and directing related initiatives.
  • Facilitating communication and information sharing across markets and impacted functions (e.g., Legal, Claims, Actuarial Services).

Requirements

• Minimum fifteen (15) years of progressive executive leadership experience in provider contracting, network development, healthcare strategy, managed care, or related healthcare environments leading enterprise transformation and governance in a matrixed organization.
• Demonstrated success managing large-scale provider spend and total cost of care initiatives through contracting, network design, and performance optimization.
• Experience negotiating and managing high-value agreements with integrated delivery systems, academic medical centers, national health systems, and large multi-specialty provider organizations.
• Track record leading negotiations involving significant financial, regulatory, and strategic implications.
• Bachelor’s degree in business, Health Administration, Public Health, or related field required.

Preferred Qualifications

• Master’s degree in business, Health Administration, Public Health, or related field highly preferred.

Pay

$423,000 - $528,750 / year

Schedule

• Full-time
• Standard shift: Monday–Friday, 08:00 AM – 05:00 PM
• Scheduled weekly hours: 40
• Travel: Yes, 25% of the time
• Work setting: Flexible (worker location must align with Kaiser Permanente’s Authorized States policy)