Vice President of Network Development - Managed Care
San Diego, CA
** Work from home most days - must be reside in greater San Diego area! **
VP of Network Development Job Summary:
VP of Network Development Background:
- Responsible for achieving regional financial metrics, benchmarks, membership targets and physician development goals, while ensuring quality and satisfying service to members, physicians and provider partners.
- Develops and implements strategic expansion plans, executes revenue-driven initiatives in a highly competitive marketplace and achieves membership growth goals via retention & new growth.
- Works closely with IPA/MSO clinical leadership to help achieve metrics while ensuring access and meeting regulatory requirements.
- Responsible for ensuring compliance with company and regulatory requirements, mandates and ACA reform.
- Identifies technology and procedure improvements for increased efficiencies, accuracy and continuous process enhancements.
- Implements strategies across all lines of business considering product-specific factors to optimize patient care and network performance.
- Bachelor’s degree required, advanced degree preferred
- 7+ years of experience in the healthcare industry, preferably with direct physician interaction
- 5+ years of experience with management and metric management in a process and/or service environment
- Strong computer skills, Word, Excel, Access, Power Point, and office equipment
- IDX experience highly desirable
- Strong written, verbal, and presentation skills
- Working knowledge of federal and state legislation related to HMO & IPA entities
- Proven success in achieving & surpassing key performance metrics, includingmembership growth, physician performance and financial targets