Oversee Provider’s Contracting and Network operational strategy for assigned market
Develop and maintain a market-specific Provider Reimbursement Strategy
Oversee the development of new reimbursement models and approval process for Health Plan exceptions
Establish and sustain relationships with regulatory agencies and other stakeholders
Manages strategic positioning for provider contracting
Oversee complex contracts and negotiations for fee for service and value-based reimbursements
Collaborate with market and enterprise committees and workgroups
Lead and develop a high‑performing contracting team
Meet or exceed projected member access, product, utilization and budget requirements
Collaborate, innovate and support provider approaches to address contract compliance

Bachelor's degree in related field required
Master's degree preferred
Ten (10) years experience in health care external stakeholder and community program support, project and program management; complex business processes, strategic and business planning or related required
Five (5) years of prior management experience required
Proficient in Microsoft Excel, Word, PowerPoint
Critical listening and systematic thinking skills
Planning, problem identification and resolution skills
Business process/management skills
Strong financial background
Ability to maintain confidentiality and act in the company’s best interest
Strong oral, written, and interpersonal communication skills
Excellent leadership, management and supervisory skills and experience
Ability to act with diplomacy and sensitivity to cultural diversity
Knowledge of regulatory reporting and compliance requirements

AVP, Network and Contracting

Key skills