Vice President of Provider Relations
1 week ago
CLevelCrossing is a leading organization in the integrated healthcare sector, committed to enhancing the well-being of its members. Our mission transcends traditional insurance roles, positioning us as a partner in health and wellness.
Position Summary:We are in search of a seasoned healthcare executive to take on the role of Vice President of Provider Relations. This pivotal position will be responsible for cultivating strategic partnerships with providers across various product lines.
The Vice President will play a crucial role in establishing provider networks that align with our organizational goals and improve community health outcomes.
Key Responsibilities:- Act as a strategic collaborator with all segments, ensuring the development and maintenance of robust network relationships with regional providers.
- Guarantee sufficient coverage of primary care, specialty, and ancillary services to meet regulatory and sales support requirements.
- Align strategies across different segments and functions, serving as the primary contact for escalated provider issues.
- Lead initiatives to transition targeted membership and providers to engagement agreements.
- Explore potential joint ventures and innovative partnership opportunities.
- Drive continuous improvement efforts regarding cost strategies and ensure access to care for members.
- Oversee Provider Performance and Analytics functions, supporting value-based contracts and initiatives.
- Maintain competitive pricing with regional providers and manage operations within a complex organizational structure.
- Incorporate provider feedback into strategic planning and enhance the overall provider experience.
- Provide leadership to regional teams focused on provider engagement, contracting, and operations.
The ideal candidate will possess extensive leadership experience in the healthcare sector, particularly in managed care and provider relations. A strong understanding of health plan finance and provider reimbursement models is essential.
Applicants should hold a Bachelor's degree, with an MBA or JD preferred, and demonstrate a successful track record in contract negotiations across various provider types.
Key qualifications include:
- Experience in leading comprehensive contract negotiations for hospitals, physicians, and post-acute care facilities.
- Ability to identify and implement cost control mechanisms within contracts.
- Strong relationship management skills, with a focus on enhancing provider satisfaction through effective communication and education.
- Prior executive leadership experience across sales, finance, legal, and health services.
- Excellent communication skills, with the ability to represent the organization positively in external forums.
This role requires a passion for improving consumer experiences and a commitment to fostering a collaborative work environment.
Scheduled Weekly Hours:40
CLevelCrossing is an equal opportunity employer and adheres to all applicable federal civil rights laws.
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