Executive Director, Network Management – Texas Network Contracting

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🔥 0 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $161.5k - $299.7k / year

⏰ Full Time

🔴 Lead

👔 Director

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Health Care Service Corporation serves nearly 23 million people across the United States through its portfolio of health benefit solutions.

📋 Description

• Develop and manage provider contracting and servicing strategies as well as value based care programs for a specific region. • Accountable for the maintenance, development, negotiation and successful completion of provider network participation contracts. Ensure appropriate coverage of networks for locations. • Oversee the contracting operations for professional providers and hospitals, for group, government and retail programs. • Achieve competitive advantage in discounts and access through contract negotiations and effective relationship management. • Develop strategies, draft agreements and negotiate contracts for newly recognized categories of providers. • Oversee the analysis and reporting required to develop payment strategies and take corrective action as needed. • Accountable for resolution of issues and contractual disputes. • Ensure staff meets/exceeds goals, objectives and initiatives. Ensure staff is trained, positions are filled, and employees receive communications on changes, etc. • Accountable for budget, operational reporting and financial reporting. • Maintain effective communications and provide support to regional counterparts in sales, marketing, and account management. • Communicate and interact effectively and professionally with co-workers, management, customers, etc. • Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. • Maintain complete confidentiality of company related business. • Maintain effective communication with Vice President, Network Management regarding developments within areas of assigned responsibilities and perform special projects as required or requested.

🎯 Requirements

• Bachelor degree and 7 years experience in health care/insurance administration, hospital/health care contracting, and hospital/physician relations. • 5 years management experience at a director level including assisting in or responsible for development of strategies and initiatives. • Knowledge of hospital and provider reimbursement strategies and policies. • Clear and concise verbal and written communications skills including interpersonal skills to represent company to external entities, negotiate contracts, resolve issues, and prepare executive and employee presentations. • Leadership skills, team player, relationship building skills. • Experience working in a fast paced environment and meeting deadlines. • Accuracy and sound judgment with regard to financial matters such as contract performance and impact. • Negotiation skills. Experience negotiating large, complex hospital and physician group contracts. • Ability and willingness to travel.

🏖️ Benefits

• Health insurance • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Other incentives