VP of Network Contracting

Location: Tacoma, WA
Date Posted: 03-30-2018
CareNational
Vice President of Network Contracting - Managed Care
Tacoma, WA 
 
VP of of Network Contracting Summary: 
  • Direct the provider network and contracting activities.
  • Lead all aspects of provider network strategy including, access analysis, network operations and support decision makers with analysis related to reimbursement and unit cost management.
  • Oversee the coordination and negotiation for the contracting department.
  • Establish the department’s strategic vision, objectives, and policies and procedures.
  • Develop, implement and maintain production and quality standards for the Contracting department.
  • Oversee network development staff and external consultants in the development of provider networks across expansion markets.
  • Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. Provide leadership in evaluating opportunities to expand or change the network to meet Company goals.
  • Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.
  • Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.
  • Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy.
  • Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
  • Assist health plan CEO and/or COO vendors in key provider relations and strategy.
VP of of Network Contracting Profile: 
  • Clinical or Non-Clinical Professional with a Bachelor's Degree in Business, Leadership, or Health Care field.  Master's degree preferred.
  • Around 7-9 years of network development and provider relations/contracting management experience, preferably in a health plan environment.
  • At least 5 years’ experience working for a Managed Care Organization (Health Plan, IPA, TPA, MSO, etc).
  • 1-2 years demonstrated experience with contract negotiations and/or provider networking.
  • Requires knowledge of managed healthcare as applied to government sponsored programs.
  • Basic computer proficiency (MS Office and Healthcare IT Systems) and typing skills are necessary.
  • Understanding of operational reports, finical budgeting processes, and health care payment models.
  • Excellent verbal and written communication skills, as well as exceptional critical thinking skills.
  • Strong oral and written communication skills; ability to interact with internal and external contacts.
  • Possess planning, organizing, conflict resolution, negotiating and interpersonal skills.
 
#ADMIN
RON AMODIO
STRATEGIC DIRECTOR
CareNational
ron@carenational.com
480.269.9491 (CALL – TEXT – FAX)
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