Director Network Management-Colorado

Elevance Health•Golden, CO

1d•Hybrid

About The Position

The Director Network Management-Colorado is responsible for network development and provider reimbursement for the Colorado Health Services Area. This leader oversees a team, managing a high-volume, complex portfolio spanning provider contracting, network adequacy, and performance management including regulatory scrutiny, network adequacy standards, and affordability initiatives.

Requirements

Requires a BS/BA degree in business administration or related healthcare field and a minimum of 8 years healthcare operations, finance, underwriting, actuary, network development and sales experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

Strong leadership for effective issue escalation and stakeholder coordination, particularly with regulators and key provider systems.
Strong analytical and relationship building skills.
Previous provider contracting experience, preferably with large health systems.
CPA or MBA degree.

Responsibilities

Oversees contracting and maintenance of all facilities including hospitals, surgery centers, etc.
Oversees the development, maintenance and reconciliation of physician risk contracts and capitated arrangement.
Attracts, develops and manages key contracting and servicing staff.
Develops innovative ways to maintain a cost effective network with adequate access and positive working relationships with providers.
Hires, trains, coaches, counsels, and evaluates performance of direct reports.