Director National Provider Strategy

Elevance Health•Woburn, MA

2d•Hybrid

About The Position

The Director National Provider Strategy is responsible for directing enterprise strategic initiatives to ensure local and national networks (e.g. individual networks, national Blues networks) are competitive in regard to network access, discounts, and quality, in order to retain and grow membership. This role will lead with large BH providers offering services nationally. How you will make an impact: Grows and retains business through competitive network access, discounts and quality. Leads initiatives to incorporate industry network developments to enhance network competitive standing. Accountable for internal and external presentations pertaining to national network strategic positioning with respect to cost, quality and access. Creates innovative solutions for growth segments, new markets and account specific needs. Leads strategic discussions internally and externally to define network best practices among health plans and implement consistent processes to improve network efficiencies. Directs the seamless delivery of network solutions services to clients, customers and members in collaboration with Local and Group Sales, Group Account Management, Health Care Management, Carelon, Individual Business Unit, Risk Adjustment, Quality, among others. Applies strategic and creative thinking to value-based contracts and alternative payment models. Manages complex internal and external relationships to drive alignment and execution. Resolves problems while coaching the team to think creatively and address operational challenges. Identifies root causes and implements proactive solutions to prevent recurrence. Engages internal and external stakeholders to build momentum and drive results. Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Requirements

Requires a BS/BA degree in health administration, business administration or related field and a minimum of 8 years of network, health care management experience or related payer experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

MHA or MBA degree strongly preferred.
Strategic thinker with creative expertise in value-based contracts and alternative payment models preferred.
Experience managing complex internal and external relationships preferred.
Demonstrated ability to solve problems, foster creative thinking, and resolve operational challenges preferred.
Ability to identify root causes and implement proactive solutions preferred.
Engaging collaborator with the ability to influence stakeholders and drive results preferred.

Responsibilities

Grows and retains business through competitive network access, discounts and quality.
Leads initiatives to incorporate industry network developments to enhance network competitive standing.
Accountable for internal and external presentations pertaining to national network strategic positioning with respect to cost, quality and access.
Creates innovative solutions for growth segments, new markets and account specific needs.
Leads strategic discussions internally and externally to define network best practices among health plans and implement consistent processes to improve network efficiencies.
Directs the seamless delivery of network solutions services to clients, customers and members in collaboration with Local and Group Sales, Group Account Management, Health Care Management, Carelon, Individual Business Unit, Risk Adjustment, Quality, among others.
Applies strategic and creative thinking to value-based contracts and alternative payment models.
Manages complex internal and external relationships to drive alignment and execution.
Resolves problems while coaching the team to think creatively and address operational challenges.
Identifies root causes and implements proactive solutions to prevent recurrence.
Engages internal and external stakeholders to build momentum and drive results.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.