Position Summary:The Assistant Vice President of UConn Health Community Network Contracting provides strategic leadership for payer contracting, network alignment, and value-based performance across the UConn Health Community Network. Working in close partnership with senior finance, operations, clinical, population health, and physician leaders, the AVP develops and executes strategies that align the academic medical center physicians, community hospitals and their employed providers, and independent medical groups around sustainable growth, improved outcomes, and responsible management of total cost of care.
This role serves as a key integrator between payer strategy and network execution. The AVP translates contract requirements into clear operating expectations, establishes performance accountability, strengthens physician and community-provider engagement, and ensures that growth and affiliation strategies are supported by viable reimbursement, data, governance, and implementation capabilities.
- Key Responsibilities
- Community Network Managed Care Strategy
- Lead development and execution of a community network managed care strategy that reflects the distinct needs of its hospitals, its home health enterprise, its employed medical groups, its CIN and any associated independent network participants.
- Advance the Community Network operating model by defining how contracting, network development, population health, analytics, finance, and clinical operations work together to achieve shared objectives.
- Assess market, payer, regulatory, and payment-reform developments and translate them into recommended network priorities, growth opportunities, and risk-mitigation strategies.
- Ensure contracting strategy supports access, referral retention, service-line growth, regional alignment, and the long-term sustainability of participating organizations.
- Payer Contracting and Value-Based Arrangements
- Lead negotiation, renewal, implementation, and ongoing oversight of commercial and government payer agreements for Community Network entities and participating providers.
- Design and negotiate value-based arrangements, including pay-for-performance, shared savings, bundled payments, care-management fees, capitation, downside risk, and other alternative payment models.
- Develop a coordinated payer approach that balances enterprise consistency with entity-specific reimbursement, operational, and market considerations.
- Establish contract guardrails, approval pathways, financial modeling requirements, implementation standards, and escalation protocols for material payer issues.
- Partner with legal, compliance, finance, revenue cycle, actuarial, and operational leaders to evaluate contract language, reimbursement methodology, attribution, risk corridors, quality terms, data rights, and termination provisions.
- Network Development, Participation, and Alignment
- Partner with network development and physician leaders to evaluate prospective hospital, provider-group, and community-practice participation using strategic, clinical, operational, financial, and payer criteria.
- Define payer participation and contracting requirements for onboarding new entities and providers, including delegated responsibilities, credentialing dependencies, roster integrity, effective dates, and implementation readiness.
- Strengthen alignment with community physicians and organizations through transparent contracting strategy, actionable performance information, and consistent issue resolution.
- Identify and address network adequacy, geographic coverage, specialty access, leakage, and referral-pattern opportunities in partnership with clinical and growth leaders.
- Contract Performance and Financial Stewardship
- Monitor payer contract performance, including revenue, medical expense, utilization, quality incentives, shared savings, risk exposure, and return on network investments.
- Establish standardized dashboards, forecasts, variance reviews, and executive reporting that provide entity-level and enterprise-level visibility into contract results.
- Coordinate with finance and analytics to validate benchmarks, attribution, risk adjustment, quality calculations, payer settlements, and distribution methodologies.
- Develop corrective action plans for underperforming contracts and ensure accountable owners, milestones, and decision points are defined.
- Recommend continuation, renegotiation, expansion, or exit strategies based on documented performance and strategic value.
- Clinical, Quality, and Population Health Integration
- Collaborate with population health, clinical, and operational leadership to translate payer obligations into practical quality, utilization, access, documentation, and patient-experience interventions.
- Align contract measures and incentives with enterprise clinical priorities while reducing unnecessary variation and administrative burden across participating entities.
- Ensure physicians and operational leaders receive timely, actionable information on performance gaps, opportunity populations, and financial implications.
- Analytics, Infrastructure, and Contract Operations
- Partner with technology, analytics, and revenue cycle teams to improve data completeness, reconciliation, interoperability, and the reliability of contract-performance reporting.
- Establish disciplined processes for contract inventory, obligation tracking, amendments, notice dates, deliverables, settlements, and document retention.
- Ensure contract implementation plans address payer configuration, provider rosters, credentialing, billing, reimbursement, patient access, communications, and operational workflows before effective dates.
- Governance, Compliance, and Executive Partnership
- Ensure contracting and network activities comply with applicable legal, regulatory, antitrust, clinical-integration, payer, and organizational requirements in partnership with counsel and compliance leaders.
- Represent the Community Network in payer, partner, and industry forums and maintain constructive executive-level relationships with external stakeholders.
- Leadership Responsibilities
- Collaborate with teams across the Community Network, including network development, finance, analytics, population health, clinical operations, revenue cycle, legal, compliance, and technology.
- Build trusted relationships with physician, hospital, and administrative leaders and create shared accountability for contract and network performance.
- Operate effectively within a matrixed environment, influencing outcomes across entities and functions without relying solely on direct authority.
- Promote a culture of disciplined execution, transparency, collaboration, innovation, and physician partnership.
- Required Qualifications
- Bachelor's degree in healthcare administration, business administration, public health, finance, accounting, or a related field required; master's degree preferred.
- Ten years of progressive healthcare leadership experience with a master's degree, or fifteen years with a bachelor's degree.
- Ten years of directly relevant experience in managed care, value-based care, population health, payer contracting, network development, or related areas.
- Demonstrated experience negotiating complex fee-for-service and value-based agreements and managing implementation and performance after signature.
- Experience with clinically integrated networks, accountable care organizations, health systems, community hospitals, or large physician enterprises.
- Working knowledge of the Connecticut payer and provider landscape, government programs, and evolving payment-reform models.
- Demonstrated financial, analytical, negotiation, communication, and executive-presentation skills.
