Lead Director, Provider Performance Value-Based Care

Role Overview

• establish and maintain productive value-based relationships with key network providers
• develop and manage the Keystone Value-based Network
• negotiate high value/risk contracts with complex arrangement structures
• manage complete value-based contracting cycle
• work with internal teams to develop a value-based strategic plan
• oversee contract performance with targeted provider groups
• evaluate and implement network strategic plans

Requirements

• 10 years of related experience
• comprehensive level of negotiating skills
• successful track record negotiating value-based contracts with IPAs
• experience reviewing medical claims data
• excellent analytical and problem-solving skills
• strong communication, negotiation, and presentation skills
• ability to work in a matrixed organization
• familiarity with legal terms in the context of provider contracting (preferred)
• experience with CMS Stars and HEDIS technical specifications (preferred)
• bachelor's degree preferred or a combination of professional work experience and education

Benefits

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources, based on eligibility