Job Description

Location: Health Choice Management Co.
Posted Date: 6/3/2020

Position Purpose: The Vice President, Network is directly responsible for developing, implementing, and leading a strategic approach to building and sustaining a robust provider network across all lines of business. Engage executive leadership in driving and prioritizing proactive initiatives that support key business objectives and drive business development opportunities.

Responsibilities:

  • Aggressively pursue opportunities to engage the provider community and stakeholders in the identification and development of quality initiatives, and innovative reimbursement models
  • Identify and advance partnership opportunities, keeping executive leadership informed of community activities and competitive approaches
  • Draft, disseminate, summarize, and analyze physician/provider data including profiles, physician scorecards, member profiles, clinical alerts systems and other key evidence-based decision support tools
  • Work in collaboration with department directors to identify potential challenges and opportunities, and work to develop consensus approaches toward improving the overall delivery system
  • Work with internal subject matter leads and executive leadership including compliance and marketing divisions to ensure consistency and coordinated engagement with the provider community
  • Direct Supervision of all department staff while providing leadership and growth of staff through planned development and coaching
  • Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. Provide guidance in evaluating opportunities to expand or change the network to meet Company goals
  • Routine, proactive and meaningful interaction with finance, medical management, operations and sales to ensure a competitive network is in place, and optimal terms and/or provisions are negotiated into contract development/updates, and implemented as intended
  • Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts
  • Valid Arizona Driver’s license required as travel is required
  • Approximately 40% travel within the state of Arizona

Education / Experience / Other Requirements

Education:

  • Bachelor’s Degree in business administration, public health, public administration, health care administration, management, finance, or related field. Master’s Degree preferred

Years of Experience:

  • 5+ years of experience in managed care network development and provider relations/contracting management in a health care and/or managed care environment
  • Previous management experience including responsibilities for hiring, training, assigning work, and managing performance of staff

Specialized Knowledge:

  • Experience with Value Based Purchasing
  • Expertise in Healthcare Network Contracting, Payment and Management
  • Experience and Knowledge of General Health Plan Operations Including Care Management
  • Experience with Network Operational Systems and Processes
  • Significant Experience Using Analytics to Measure and Improve Provider and Health Plan Performance
  • Advanced Knowledge of Provider Cost, Utilization and Quality Measurement
  • Experience Leading Development of Proactive and Effective Provider Relations
  • Experience with Healthcare Network Building and Management

Skills & Abilities

  • Experience Building and Managing Teams
  • Comfortable Managing Regional Teams and Processes
  • Track Record of Improving Processes, Teams and Performance
  • Strategic and Critical Thinking Skills
  • Problem Solving/Analysis
  • Communication Proficiency
  • Strong Presentation Skills
  • Experience Collaborating with Teams, Vendors and Resources
  • Budgeting and Financial Management
  • Decision Making Abilities
  • Results Driven and Client Focused
  • Initiative and Proven Organization Skills
  • Proactive Problem-Solver Focused on Quality Improvement

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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