Senior Director, Provider Network Performance
About The Position
Oversee provider network performance and communications across the company to inform and educate providers and improve quality of care. The role focuses on improving quality and access at lower costs while maintaining compliance with policies, standards, government laws, and regulations. It oversees provider satisfaction initiatives, provider communications and training, enterprise metrics and reporting, and the rollout of provider engagement strategies across corporate functions and health plans. The position also oversees provider education materials and policies, plans for future needs, data accuracy in partnership with other leaders, and resolution of complex provider projects, including direct provider communication. This is a remote position that requires travel to the New York offices; candidates in New York or bordering states are preferred. Applicants must be authorized to work in the United States without current or future employment-based visa sponsorship.
Requirements
- Bachelor's degree in business administration, healthcare administration, or a related field.
- At least 8 years of provider relations or contracting experience.
- Previous management experience, including responsibility for hiring, training, and managing staff performance.
- Must be authorized to work in the U.S. without current or future employment-based visa sponsorship.
Nice To Haves
- Master’s degree.
- Provider relations or contracting experience in a managed care or Medicaid environment.
- Experience leading major projects and change initiatives.
- Candidate based in New York or a bordering state.
Responsibilities
- Oversee provider network performance and communications to improve quality and access at lower costs and maintain compliance with policies, standards, government laws, and regulations.
- Oversee provider satisfaction programs and initiatives, best practices, and reporting tools in partnership with leaders across the enterprise.
- Oversee provider communications and training on products, services, and tools.
- Develop enterprise metrics and reporting tools to support quality and cost improvement activities.
- Develop and implement plans and tactics to deploy and expand the provider engagement model across corporate functional areas and health plans.
- Oversee implementation of provider education materials and monitor policies and procedures.
- Develop tactical plans to align strategies and technologies with future needs.
- Partner with leaders in Credentialing, PDM, Contracting, and Shared Services to ensure the accuracy of provider-related data.
- Oversee and direct resolution of complex provider projects, including direct communication with providers.
- Hire, train, and manage staff performance.
Benefits
- Competitive pay.
- Health insurance.
- 401(k) and stock purchase plans.
- Tuition reimbursement.
- Paid time off and holidays.
- Flexible approach to work, with remote, hybrid, field, or office schedules.
- Additional incentives may be included in total compensation.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
