Director Provider Solutions-New Jersey
Director Provider Solutions-New Jersey
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$ 174800 - 273600
1 Vacancy
Job Description
Anticipated End Date:
Position Title:
Director Provider Solutions-New JerseyJob Description:
Director Provider Solutions-New Jersey
Location: New Jersey. This role requires associates to be in-office 3 days per week fostering collaboration and connectivity while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work promoting a dynamic and adaptable workplace.
Please note that per our policy on hybrid/virtual work candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.
The Director Provider Solutions is a dynamic and results-oriented leader committed to healthcare transformation through strategic leadership over all provider engagement and contracting activity in the New Jersey market. This role will oversee all lines of business and lead enterprise-wide initiatives to include local cost of care and trend management innovative provider contracting implementation of cutting-edge payment programs and fostering robust provider relations and education.
How you will make an impact:
- Delivers competitive cost of care trends throughout New Jersey positively impacting the affordability of respective health plan products.
- Develops new provider networks that establish a competitive advantage optimizing respective provider relationships to most effectively benefit health plan growth priorities.
- Aligns contracting strategy with medical management strategy integrating quality metrics and unique (non-traditional) incentives into the overarching contracting process shepherding a market transition from fee-based reimbursement to a model based on quality achievement.
- Serves as PE&C local single point of accountability for all product lines and is the state lead for the Integrated Cost Management (ICM) committee.
- Facilitates the implementation of local system and product consolidation efforts.
- Ensures compliance with regulatory and accreditation standards.
- Mentors hires trains coaches counsels and evaluates the performance of direct reports.
Minimum Qualifications:
- Requires BS/BA in business administration or related healthcare field and a minimum of 8 years of experience in healthcare operations finance underwriting actuary network development and/or sales; or any combination of education and experience which would provide an equivalent background.
Preferred Skills Capabilities and Experiences:
- Strongly preferred MBA degree.
- Proven Network provider and contracting experience including Value-Based Care Fee-for-Service and unit price contract experience.
- Excellent contracting analytical and negotiation (listening) skills needed.
- Proven experience developing relationships both internal to the organization and external client facing.
- Experience in the New Jersey health insurance market.
For candidates working in person or virtually in the below location(s) the salary* range for this specific position is $174800 to $273600.
Locations: Iselin NJ Morristown NJ New York NY.
In addition to your salary Elevance Health offers benefits such as a comprehensive benefits package incentive and recognition programs equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender race or any other category protected by federal state and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location work experience education and/or skill level. Even within the range the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned vested and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus commission benefits or any other form of compensation and benefits that are allocable to a particular employee remains in the Companys sole discretion unless and until paid and may be modified at the Companys sole discretion consistent with the law.
Job Level:
DirectorWorkshift:
Job Family:
PND > Network ContractingPlease be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes including those submitted to hiring managers are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy power our business outcomes and drive our shared success - for our consumers our associates our communities and our business.
We offer a range of market-competitive total rewards that include merit increases paid holidays Paid Time Off and incentive bonus programs (unless covered by a collective bargaining agreement) medical dental vision short and long term disability benefits 401(k) match stock purchase plan life insurance wellness programs and financial education resources to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager associates are required to work at an Elevance Health location at least once per week and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age citizenship status color creed disability ethnicity genetic information gender (including gender identity and gender expression) marital status national origin race religion sex sexual orientation veteran status or any other status or condition protected by applicable federal state or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Required Experience:
Director
Employment Type
Full-Time
