Director Network Development
Director Network Development
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Job Description
Senior leader who provides strategic leadership and oversight for network management and contracting team. Develops and implements network strategies manage provider contracts and negotiations leads dispute resolution processes and collaborates with key stakeholders to drive network growth and ensure high-quality provider relationships.
Duties And Responsibilities:
Manages contract negotiations with Major Health Systems large physician groups and ancillary providers; conducting several negotiations simultaneously to meet growth demands
Deep understanding and experience with all clinical specialties to ensure contract terms and conditions address the coding structures which are most impacted by negotiations
People manager and mentor. Will directly manage a team of negotiators.
Proactively builds relationships that nurture provider partnerships to support the local market strategy
Initiates nurtures and maintains effective channels of communication with matrix partners including but not limited to Claims Medical Management Credentialing Legal Medical Economics Compliance Sales and Marketing
Responsible for meeting unit cost targets while preserving an adequate network to achieve and maintain competitive position
Identify and manages initiatives that improve total medical cost and quality; including renegotiation of existing agreements
Prepares analyzes reviews and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms
Collaborates cross-functionally to manage provider compensation and pricing development activities submission of contractual information and the review analysis of reports as part of negotiation and reimbursement modeling activities.
Assists in resolving elevated provider service complaints; researching and negotiating with internal/external partners/customers to resolve complex and/or escalated issues.
Manages key provider relationships and is accountable for critical interface with providers and business staff
Coach and support newer team members on strategies and approaches to successful negotiations
Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape
Partner with Regulatory Affairs to ensure all network filings are timely and accurate; including participation with Compliance to ensure adherence to established guidelines supporting Mental Health Parity.
Requirements / Qualifications:
A minimum of 15 years professional work experience in provider network management with Texas hospital and/or large group and ancillary contracting experience
Superior problem solving decision-making negotiating skills contract language and financial acumen
In depth understanding of the contract cycle from contractual negotiation to credentialing and contract terms load
Hospital / Health Systems Large Physician Groups and Ancillary provider contracting and negotiations
Experience in developing and managing key provider relationships including senior executives
Demonstrated experience in seeking out building and nurturing strong external relationships with provider partners
Team player with proven ability to develop strong working relationships within a fast- paced organization
Customer centric and interpersonal skills are required
5 years of being a people manager
Experience with Google products
Education Requirements:
Bachelors degree or equivalent experience in related field.
Required Experience:
Director
Employment Type
Full-Time
