Position Purpose: Oversee activities of the provider contracting, network development and/or provider relations functions and aid in formulating and administering organizational policies and procedures.
- Oversee provider contracting activities to ensure efficiency and maintain compliance with the business unit’s policies and standards, government laws and regulations
- Implement development activities for the recruitment and contracting of provider networks in new and prospective markets, and existing market expansions.
- Support new business launch in diverse markets while considering individual market circumstances, provider community, budgeting constraints and available resources
- Perform complex financial analyses to identify medical cost improvement opportunities, develop strategies to reach financial goals, and execute contracting strategies to meet goals and objectives
- Oversee contracting and network development staff and external consultants in the development of provider networks for new and expansion markets
- Monitor performance, develop, and implement business solutions to address process and quality gaps, and communicate network strategy and planning
- Ability to travel
Education/Experience: Bachelor's degree in Business Administration, Health Care Administration, related field or equivalent experience. 7+ years of combined contracting, network development or provider relations experience. Previous experience in Medicaid/Medicare contracting and negotiating hospital, large physician groups and ancillary service agreements. Previous management experience including responsibilities for hiring, training, assigning work and managing the performance of staff. License/Certification: Valid driver's license.