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Strategic Network Development Manager
2 months ago
VNS Health Plans is seeking a highly skilled Strategic Network Development Manager to develop and implement the overall network strategy for our Health Plans Networks and associated Provider Relations Department.
Key Responsibilities:- Develops and implements network strategy and drives provider management opportunities to support achievement of member growth and increased quality and efficiency.
- Identifies and recommends best practices for operational improvements and performance for Health Plans.
- Reviews and manages unit cost structures and achievement of overall MLR targets; works closely with Health Plans leadership, finance, and clinical areas to review network and provider performance.
- Leads the development and negotiation of contractual relationships with external vendors and manages the oversight of relationships.
- Develops and implements strategies to meet network capacity and regulatory requirements.
- Monitors and analyzes network needs through review of provider utilization, member demands, and market trends.
- Directs all provider recruitment activity and oversees the recruitment process to identify and establish relationships with various service providers.
- Ensures compliance with all regulatory reporting requirements and maintains visibility in the provider community.
- Bachelor's Degree in Business, Health Administration, Health Policy, or a related discipline.
- Master's Degree in Business, Health Administration, Health Policy, or a related discipline.
- Minimum ten years of experience in healthcare, with a minimum five years in a managed care environment and five years in healthcare management.
- Experience negotiating hospital, IPA, Nursing Homes, LHCSAs, and provider contracts.
- Experience negotiating risk and Value Based Payment contracts.
- Competitive compensation and benefits package.
- Opportunities for professional growth and career advancement.
- Collaborative and dynamic work environment.
- Recognition and rewards for outstanding performance.
VNS Health Plans is a leading health insurance company dedicated to providing high-quality healthcare services to our members. We are committed to delivering exceptional customer service and promoting healthy lifestyles through education and community outreach.
