ABOUT THIS ROLE
Our Markets Team is responsible for developing and managing the long-term strategy, relationships, and contracts with our Care Partners and top network providers, as well as assisting in making our insurance product offerings in local markets successful. The Markets Team is comprised of Bright Health's Market Leadership and Provider Relations functions, which collectively serve to support the implementation of our health plans in each market, track and drive performance of these plans, and foster strategic alignment between Bright Health, our Care Partners, and our local network of providers.
As a Market Lead, you will also have accountability for our Care Partners relationships, top network providers in your market, and ensuring successful market launch, operations, and growth. You will be critical to the delivery and execution of our provider engagement and network contracting strategy, ensuring Bright Health has an effective network to serve customers across your market. We anticipate that your work will impact Care Partner and key provider NPS and clinical effectiveness by ensuring we have a successful approach to supporting the development and implementation of Care Partner/Bright Health quality and clinical programs, panel and attribution growth initiatives and advancing Care Partner primary care delivery models. The role will collaborate closely with Bright Health's internal teams, as well as our Care Partners and top provider practices, while overseeing a team that is the face of Bright to providers across your market. You will help to evolve our Care Partner model of care as we continue to scale and grow within markets and across the country.
- Oversee and execute Bright's Care Partner Engagement and Performance strategy within your assigned territory and region. As part of this, you will be responsible for implementing and operating a provider engagement model that works best for each of our Care Partners and other top provider practices.
- Support the development of provider contracting efforts from start-to-finish, including but not limited to strategic diligence, outreach, contract negotiation and execution.
- Work closely with the Care Partner and providers on day-to-day health plan operations
- Oversee local network strategy, including network development, contracting, provider relations, and local operations.
- Work closely with the DOI and Bright Health legal team to ensure compliance
- Closely collaborate with the sales team in executing on high revenue and membership targets.
- Partner closely with Health Optimization and Bright Implementation Team to implement programs to maintain positive relationships between the health plan, physicians, hospitals, and practice managers
- Works closely with Care Partner Development team on new market entry strategies, including product launches and market expansions.
- Other duties and responsibilities as assigned.
- This position has supervisory responsibilities for Provider Relations Specialists.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- A Bachelor's Degree in business, economics, healthcare administration, or a related field is required; MBA is preferred
- Seven or more (7+) years of experience in healthcare, ideally inside provider and payer settings, with at least three or more (3+) years of experience or knowledge of managed care, network development, or network management
- Local market knowledge of the healthcare payer and/or provider landscape
- Large project and program management experience.
- Experience with Provider Engagement and Performance strategies, including defining, implementing, and operating a provider engagement model.
- Ideally has familiarity with Commercial and Medicare products
- Experience working with clinical, sales, and product teams to design and implement programs to maintain positive relationships between the health plan, physicians, hospitals, and practice managers.
- Strong collaboration skills to effectively work with the sales team in executing on high revenue and membership targets, as well as partnering closely with Health Optimization and Bright Experience Team to design and implement programs to maintain positive relationships between the health plan, physicians, hospitals, and practice managers.
- Leadership skills that extend cross-functionally, spanning operations, clinical, provider relations and sales that contribute to driving an exceptional experience for members and for clinicians.
- Strong relationship and account management skills within the healthcare provider space
- Results oriented, capable of clearly translating strategic objectives into implementable processes that drive outcomes.
BEHAVIORAL AND LEADERSHIP NORMS
- Bright Values: Lives the Bright Values. Leads by example. Is viewed as an emerging leader in the company. Acts with quiet, calm determination. Effectively influences inside of the organization.
- Decision making: Drives strong decision making at a functional level. Is capable of taking a large sum of information, and drilling into what is important. Understands organizational impact of decisions and communicates effectively throughout the decision-making process. Pushes issues to resolution.
- Delivers Results: Is results oriented. Is capable of deciphering priorities for self and for others, and focuses the group on what must be done today, and who must do what. Is capable of clearly translating strategic objectives into implementable processes that drive outcomes. Focuses on results, not effort, and is able to efficiently direct time and energy to achieving intended outcome. Can successfully develop a budget and achieve it without sacrificing quality of output. Achieves strong results within their functional area. Has an excellent track record of achieving expected results. Understands how to operate in collaborative framework.
- Direct and Indirect Management: Demonstrates leadership skills. Has mastered autonomous work, and is able to successfully influence direct and indirect teams to achieve goals. Organizes people and resources toward the effective and pursuit of objectives: this includes hiring, firing, efficient supervising and performance appraisals. Delivers thoughtful and constructive feedback to teams, and actively works to develop those around them. Sets an example for our employees. Manages up appropriately and knows how and when to escalate an issue or situation to more senior manager.
- Planning and Execution: Identifies need for planning and has skills to develop, implement, monitor and achieve plans. Knows how and when to adjust plan. Leads others in this effort. Hold self and team accountable for effective planning and execution. Overcomes hurdles.
- Presence: Internally, leads large and small groups of people in meetings. Capable of developing thoughtful agenda, setting objectives, driving clarity of purpose and delivering the intended results. Instills confidence.
The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Some travel may be required.