About The Position

Inspire health. Serve with compassion. Be the difference. Job Summary The Director, Network Development and Operations is responsible for directing and operationalizing on strategy for all enterprise network partnerships with provider organizations. Network partnerships span the Clinically Integrated Network (CIN), the Promise Health Plan Network, and any other related clinical and network partnerships to be developed thereafter. This role is integral to supporting the enterprise growth strategy through operationalizing on strong provider relationships, rollout of robust clinical provider communication strategy, and recruitment of new partnerships in collaborations with the product and operation, growth, and contracting teams. This role requires a comprehensive understanding of provider financial issues, value-based contracting methodologies, competitive programs and services, quality performance measurement, network service adequacy, and promotion of models, tools, and technology for all Network partnerships.

Requirements

  • Bachelor's Degree - Health Administration, Public Health, Health Science, Business, or Economics
  • 6+ years of network relations development, building and maintaining relationships with providers or health systems, experience in value-based contracting, and/or managed care services, or other applicable health experience.
  • Knowledge of office equipment and basic computer skills including MS Office 360, PowerPoint, Excel, and databases.
  • Network Development and provider recruitment/retention.

Responsibilities

  • Directs and operationalizes with high precision the strategy for the southeast US, which includes all provider and facility types, with the goal of ensuring network adequacy in desired catchment areas.
  • Serves as core leader for Promise Health Plan's network development and growth - leading all facets of network strategy, design, and provider recruitment.
  • Serve as core leader for InVio Health (Clinically Integrated Network) network development and growth - leading network strategy, design, and provider recruitment.
  • Develop and operationalize a formalized process for relaying market intelligence to applicable internal teams related to new programs and resources for providers, new competitive threats, and other applicable needs to ensure the integrity of the network is maintained.
  • Utilizing data driven approach, plan, develop, and implement a geographically competitive, broad access network that meets objectives for unit cost performance and trend management.
  • Collaborates with Product & Operations team on product offering roadmap to ensure ability of network to deliver through all necessary access points for new products.
  • Proactively reviews quality performance and volume data to align data with strategic goals and works effectively with other functional leaders to drive support and execution of key initiatives.
  • Maintains expert level of knowledge regarding health care reimbursement methodologies and contract models as well as competitor programs and services.
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