AVP, Network and Contracting

Emploi pas sur LinkedIn

🕒 il y a 20 jours

🇺🇸 États-Unis – Télétravail

💵 $150 000 - $300 000 / an

⏰ Temps Plein

🔴 Expert

👔 Vice-président

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CareSource

Site WebLinkedInTous les Emplois

1001 - 5000 employés

Fondée en 30+ years

⚕️ Assurance santé

Healthcare Insurance

CareSource est une entreprise de services de santé axée sur la fourniture d'assurances santé abordables et de solutions de soins de santé. Elle propose une large gamme de plans incluant Medicaid, le Marketplace et Medicare Advantage, visant les adultes à faible revenu, les familles, les enfants, les femmes enceintes, les personnes âgées et les personnes handicapées. De plus, CareSource fournit à ses membres des ressources pour le soutien COVID-19, des avantages dentaires, visuels et auditifs, ainsi que des services de pharmacie. L'entreprise met l'accent sur l'accès facile à la gestion des soins de santé via des plateformes en ligne et une application mobile.

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

🎯 Exigences

• 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

🏖️ Avantages

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