AVP, Network and Contracting

Job not on LinkedIn

🕒 May 15

🇺🇸 United States – Remote

💵 $150k - $300k / year

⏰ Full Time

🔴 Lead

👔 Vice President

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

⚕️ Healthcare Insurance

Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

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