Director, Network Development – Texas Region

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🕒 vor 8 Tagen

🤠 Texas – Remote

🤠 Texas – Remote

💵 $150.000 - $175.000 / Jahr

⏰ Vollzeit

🔴 Experte

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Curative

WebsiteLinkedInAlle Stellen

501 - 1000 Mitarbeiter

Gegründet 2020

🏥 Gesundheitswesen

🛡️ Versicherung

Healthcare • Insurance

Curative ist ein arbeitgeberzentriertes Krankenversicherungsunternehmen, das einen innovativen Gruppengesundheitsplan anbietet, der sich durch Erschwinglichkeit, Engagement und Einfachheit auszeichnet. Ihre Pläne versprechen $0 Zuzahlungen im Netzwerk, $0 Selbstbehalte und eine einheitliche, wettbewerbsfähige monatliche Prämie, zusammen mit einem breiten Anbieternetzwerk, Telemedizin, einem umfangreichen $0-bevorzugten Rezeptformular, Betreuungsnavigatoren und der Curative Cash Card, um Selbstkosten in vielen Bereichen zu eliminieren. Curative richtet sich an Arbeitgeber und Makler, während es den Mitgliedern Ressourcen wie einen Baseline-Besuch, Pflegeprogramme, Online-Portale und Apothekendienste bietet und ein A- Rating von AM Best sowie die HITRUST r2-Zertifizierung besitzt.

Beschreibung

• Manages contract negotiations with Major Health Systems, large physician groups in West and North Texas; national ancillary providers; conducting several negotiations simultaneously to meet growth demands • Deep understanding and experience with all complex contracts 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. • Able to work in a fast-paced environment with high volume contracting requirements for the role. (Position will be responsible for completing a minimum number of contracts per month as well as managing the team to do the same.) • Proactively build 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 and identify and manage 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

🎯 Anforderungen

• A minimum of 10 years professional work experience in provider negotiating and contracting with north Texas hospitals and/or affiliated large group contracting experience • Bachelor’s degree or equivalent experience in related field. • Remote with occasional travel (5-10%) • Existing relationships with major health systems and large physician groups in north Texas • 7+ years of experience with health plan or provider organizations • 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, high-volume organization • Customer centric and interpersonal skills are required • 5+ years of being a people manager • Experience with Google products

🏖️ Vorteile

• Curative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.) • $0 copays and $0 deductibles (with completion of our Baseline Visit) • Preventive and primary care built in • Mental health support (Rula, Televero, Two Chairs, Recovery Unplugged) • One-on-one care navigation • Chronic condition programs (diabetes, weight, hypertension) • Maternity and family planning support • 24/7/365 Curative Telehealth • Pharmacy benefits • Comprehensive dental and vision coverage • Employer-provided life and disability coverage with additional supplemental options • Flexible spending accounts • Flexible work options: remote and in-person opportunities • Generous PTO policy plus 11 paid annual company holidays • 401K for full-time employees • Generous Up to 8–12 weeks paid parental leave, based on role eligibility.