Network Strategy Director – Preferred Experience In Managed Care

🕒 il y a 6 jours

🇺🇸 États-Unis – Télétravail

💵 $113 000 - $197 700 / an

⏰ Temps Plein

🔴 Expert

🧐 Stratégie

🗣️🇺🇸🇬🇧 Anglais requis

D'où vient cette offre

Publiée sur la page carrières de CareSource, pas via un site d'emploi

Repérée par Remote Rocketship il y a 6 jours

Toujours ouverte sur le site de CareSource. Vérifiée il y a 19 minutes.

Logo of CareSource

CareSource

1001 - 5000 employés

Fondée en 30+ years

🏥 Santé

🛡️ Assurance

⚕️ Assurance santé

Healthcare • Insurance • 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

• Lead negotiation of CareSource's largest and most strategically significant provider agreements, including major health systems, multi-market IDNs, and national/DME vendor contracts • Serve as the enterprise subject-matter expert on contracting strategy, reimbursement methodology, and deal structuring • Advise leadership on negotiation approaches for high-stakes deals • Design and pilot novel contract structures, including advanced VBC arrangements, risk corridors, and performance-based rate mechanisms • Mentor contracting professionals enterprise-wide • Partner cross-functionally to resolve complex contractual, financial, and regulatory issues • Represent National Network Development in executive-level provider discussions and market-facing negotiations • Own strategic renewal planning for highest-exposure agreements using 90/180/365-day windows • Contribute contracting expertise to enterprise initiatives such as new market entry readiness, network optimization pilots, and VBC expansion strategy • Perform other job-related duties as requested

🎯 Exigences

• Bachelor's degree in a business-related field required • Equivalent years of relevant work experience may be accepted in lieu of required education • Eight (8) years of provider contracting experience required • Demonstrated track record leading complex, high-dollar, multi-stakeholder negotiations independently • Direct experience negotiating with major health systems or IDNs preferred • Experience designing value-based or risk-based contract structures preferred • Expert-level knowledge of reimbursement methodology and contract law fundamentals • Ability to design and defend novel contract structures • Sophisticated financial and risk analysis • Expert-level negotiation and deal architecture • Enterprise strategic thinking • Executive presence and provider-facing credibility • Mentorship and technical leadership without formal authority • Complex risk and financial structuring • Up to 15% occasional travel may be required

🏖️ Avantages

• Bonus tied to company and individual performance may be available • Comprehensive total rewards package • Employee total well-being support

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