Vice President, Network Development & Contracting

About the Role

Direct the provider network and contracting activities. Lead all aspects of provider network strategy including access analysis, network operations, and support decision makers with analysis related to reimbursement and unit cost management. Oversee the coordination and negotiation for the contracting department. Establish the department’s strategic vision, objectives, and policies and procedures. Develop, implement, and maintain production and quality standards for the Contracting department.

Responsibilities

• Oversee network development staff and external consultants in the development of provider networks across expansion markets.
• Perform periodic analyses of the provider network from a cost, coverage, and growth perspective.
• Provide leadership in evaluating opportunities to expand or change the network to meet Company goals.
• Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.
• Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.
• Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy.
• Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
• Assist health plan CEO and/or COO vendors in key provider relations and strategy.
• Travel up to 25%.
• Perform other duties as assigned.

Requirements

• Bachelor's Degree or equivalent experience in Business Administration, Healthcare Administration, or related field required. MBA or MHA degree preferred.
• 10+ years of experience in managed care network development and provider relations/contracting management in a health care and/or managed care environment required.
• Previous management experience including responsibilities for hiring, training, assigning work, and managing performance of staff, or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope, and skill reflective of the level of this position.

Pay

$188,900.00 - $359,800.00 per year. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives.

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

Benefits may be subject to program eligibility.