Role Overview: The Corporate Director of Network Strategy leads the development and management of an enterprise-wide provider network strategy focused on optimizing total network value. This role is responsible for designing and executing data-driven provider network strategies informed by advanced market research, competitive intelligence, contracting, and analytics to support strategic network decisions and new program development. The position considers volume, cost, quality, access, and member and provider satisfaction in guiding network strategy and performance.
Work Arrangement:- This position is fully remote and may be performed from any location within the United States, with required availability during Eastern Standard Time (EST) hours.
- Ability to travel within the U.S. as needed.
- Associates must have access to a reliable high-speed internet connection capable of supporting daily responsibilities, with a minimum bandwidth of 50 Mbps download and 5 Mbps upload. Fully remote associates residing in states where reimbursement is required by contract, law, or regulation may submit for appropriate expense reimbursement.
Responsibilities:- Responsible for collaborating with business development, product leadership, medical management, pricing, and actuary, provider performance programs, and local provider network resources to lead and deploy programmatic solutions, as well as to respond to proposals.
- Manages operational reporting team, as well as the provider experience team, including provider communications, training, and measurement.
- Collaborate with health plan/market and corporate leaders to drive new market network strategies and build a plan
- Collaborates with Health Plan Leaders on the identification and pursuit of new or renegotiated contracts with national providers.
- Collaborates with Strategy & Finance on the design, while complying with each state's regulatory requirements.
- Support existing market contracting and re-contracting strategies with standardized enterprise tools and capabilities, by overseeing the development and synthesis of detailed analyses of delivery systems, inventoried provider universes, and prioritized targets.
Education & Experience:- Bachelor's degree required
- MBA or MHA strongly preferred
- 10 plus years of contract negotiation experience within a managed care environment, spanning multiple provider and product types, including ACOs, hospitals, physician groups, ancillary providers, and lines of business such as Medicaid, Medicare, ACA Exchange, and LTSS.
- 5 years of network strategy experience
- Experience utilizing competitive intelligence, financial analysis, health value optimization (HVO) contract modeling, contract standards, and contracting strategies
- Proven leadership and mentoring skills, with experience developing high-performing teams.
- Proven success working in a highly matrixed environment
Skills & Abilities:- Strong strategic leadership and analytical capabilities, with the ability to translate complex data into actionable network strategies
- Deep understanding of provider network strategy, contracting, and managed care.
- Experience leading and developing cross-functional teams
- Excellent written, verbal, and executive-level presentation skills, with the ability to communicate complex concepts clearly to leadership
- High degree of collaboration and stakeholder engagement
- Ability to influence strategy, build consensus, and drive outcomes across diverse teams and markets
