AVP, Network and Contracting

Vaga não está no LinkedIn

🕒 Maio 15

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $150.000 - $300.000 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Vice-presidente

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CareSource

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 30+ years

⚕️ Seguro de Saúde

Healthcare Insurance

CareSource é uma empresa de serviços de saúde focada em fornecer soluções acessíveis de seguro saúde e assistência médica. Oferece uma ampla gama de planos, incluindo Medicaid, Marketplace e Medicare Advantage, direcionados a adultos de baixa renda, famílias, crianças, gestantes, idosos e pessoas com deficiência. Além disso, a CareSource oferece aos membros recursos para suporte ao COVID-19, benefícios odontológicos, de visão e audição, bem como serviços de farmácia. A empresa enfatiza o fácil acesso ao gerenciamento de saúde por meio de plataformas online e um aplicativo móvel.

Descrição

• Oversee Provider’s Contracting and Network operational strategy for assigned market • Develop and maintain a market-specific Provider Reimbursement Strategy • Oversee the development of new reimbursement models and approval process for Health Plan exceptions • Establish and sustain relationships with regulatory agencies and other stakeholders • Manages strategic positioning for provider contracting • Oversee complex contracts and negotiations for fee for service and value-based reimbursements • Collaborate with market and enterprise committees and workgroups • Lead and develop a high‑performing contracting team • Meet or exceed projected member access, product, utilization and budget requirements • Collaborate, innovate and support provider approaches to address contract compliance

🎯 Requisitos

• Bachelor's degree in related field required • Master's degree preferred • Ten (10) years experience in health care external stakeholder and community program support, project and program management; complex business processes, strategic and business planning or related required • Five (5) years of prior management experience required • Proficient in Microsoft Excel, Word, PowerPoint • Critical listening and systematic thinking skills • Planning, problem identification and resolution skills • Business process/management skills • Strong financial background • Ability to maintain confidentiality and act in the company’s best interest • Strong oral, written, and interpersonal communication skills • Excellent leadership, management and supervisory skills and experience • Ability to act with diplomacy and sensitivity to cultural diversity • Knowledge of regulatory reporting and compliance requirements

🏖️ Benefícios

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements • Professional development opportunities • Bonuses • Comprehensive total rewards package