Executive Director, Network Management – Texas Network Contracting

Role Overview

• Develop and manage provider contracting and servicing strategies as well as value based care programs for a specific region.
• Accountable for the maintenance, development, negotiation and successful completion of provider network participation contracts. Ensure appropriate coverage of networks for locations.
• Oversee the contracting operations for professional providers and hospitals, for group, government and retail programs.
• Achieve competitive advantage in discounts and access through contract negotiations and effective relationship management.
• Develop strategies, draft agreements and negotiate contracts for newly recognized categories of providers.
• Oversee the analysis and reporting required to develop payment strategies and take corrective action as needed.
• Accountable for resolution of issues and contractual disputes.
• Ensure staff meets/exceeds goals, objectives and initiatives. Ensure staff is trained, positions are filled, and employees receive communications on changes, etc.
• Accountable for budget, operational reporting and financial reporting.
• Maintain effective communications and provide support to regional counterparts in sales, marketing, and account management.
• Communicate and interact effectively and professionally with co-workers, management, customers, etc.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
• Maintain complete confidentiality of company related business.
• Maintain effective communication with Vice President, Network Management regarding developments within areas of assigned responsibilities and perform special projects as required or requested.

Requirements

• Bachelor degree and 7 years experience in health care/insurance administration, hospital/health care contracting, and hospital/physician relations.
• 5 years management experience at a director level including assisting in or responsible for development of strategies and initiatives.
• Knowledge of hospital and provider reimbursement strategies and policies.
• Clear and concise verbal and written communications skills including interpersonal skills to represent company to external entities, negotiate contracts, resolve issues, and prepare executive and employee presentations.
• Leadership skills, team player, relationship building skills.
• Experience working in a fast paced environment and meeting deadlines.
• Accuracy and sound judgment with regard to financial matters such as contract performance and impact.
• Negotiation skills. Experience negotiating large, complex hospital and physician group contracts.
• Ability and willingness to travel.

Benefits

• Health insurance
• 401(k) savings plan
• Pension plan
• Paid time off
• Paid parental leave
• Disability insurance
• Supplemental life insurance
• Employee assistance program
• Paid holidays
• Tuition reimbursement
• Other incentives