Director, Network Development – Mid Atlantic Region

🕒 il y a 2 mois

🌲 North Carolina, Pennsylvania, +1 états de plus – Distant

🌲 North Carolina – Remote 🔔 Pennsylvania – Remote ⚔️ Virginia – Remote

💵 $175 000 - $200 000 / an

⏰ Temps Plein

🔴 Expert

👔 Directeur

👻 Score fantôme 22%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Curative

Site WebLinkedInTous les Emplois

501 - 1000 employés

Fondée en 2020

🏥 Santé

🛡️ Assurance

Healthcare • Insurance

Curative est une entreprise d'assurance santé orientée vers les employeurs, proposant un plan de santé de groupe de nouvelle génération mettant l'accent sur l'accessibilité financière, l'engagement et la simplicité. Leurs plans promettent zéro frais de consultation en réseau, zéro franchise et une prime mensuelle unique et compétitive, accompagnés d'un large réseau de prestataires, de télémédecine, d'une vaste liste de médicaments préférentiels à zéro, de navigateurs de soins et de la Curative Cash Card pour éliminer les coûts à la charge des membres dans de nombreux contextes. Curative s'adresse aux employeurs et courtiers tout en fournissant aux membres des ressources telles qu'une visite de base, des programmes de soins, des portails en ligne et des services de pharmacie. L'entreprise détient une note A- de AM Best et la certification HITRUST r2.

Description

• Manages contract negotiations with Major Health System and large physician groups and ancillary providers; conducting several negotiations simultaneously to meet growth demands • Deep understanding and experience with all clinical specialties to ensure contract terms and conditions address the coding structures which are most impacted by negotiations • Proactively builds 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 • Identify and manages 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 • This position assumes and performs other duties as assigned.

🎯 Exigences

• Superior problem solving, decision-making, negotiating skills, contract language and financial acumen • Experience with complex Hospital / Health Systems, Large Physician Groups and Ancillary provider contracting and negotiations • Experience negotiating delegated credentialing agreements • 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 • Intimate understanding and experience with larger, more complex integrated delivery systems managed care, and provider business models • Team player with proven ability to develop strong working relationships within a fast- paced organization • The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations • Customer centric and interpersonal skills are required

🏖️ Avantages

• 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.