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Strategic Director, Provider Network Development

2 months ago

Madison Wisconsin, United States Quartz Full time
AVP, Provider Network Management

At Quartz, we are dedicated to improving the health and well-being of our members through innovative partnerships with healthcare delivery systems.

About the Role

We are seeking a results-driven leader with a proven track record in developing mutually beneficial partnerships with healthcare providers across our markets in Wisconsin, Illinois, Iowa, and Minnesota.

Key Responsibilities
  • Team Leadership: Build, manage, coach, and develop a high-performing team that will own specific projects and relationships.
  • Stakeholder Engagement: Proactively engage, collaborate, and maintain strong working relationships with key internal stakeholders and key owner system stakeholders.
  • Operational Strategy: Translate business vision and strategy into clear operational goals, objectives, and tactics that ensure the necessary infrastructure, skills, and competencies needed are available to achieve business objectives and overall success.
  • Contract Management: Develop and implement contract workflows, standardize policies and procedures to optimize performance, decrease errors, and meet state and federal regulations.
  • Value-Based Solutions: Drive Value-Based solutions that optimize financial performance, quality, risk adjustment, and clinical programs.
  • Risk Adjustment Optimization: Develop innovative strategies to continually optimize Quartz's risk adjustment performance and supplement the risk adjustment activities of owner systems and network providers.
  • Vendor Management: Add, consolidate, or eliminate vendors as necessary to continually optimize the collective performance, efficiency, and cost-effectiveness of Quartz's risk adjustment, credentialing, and network adequacy solutions.
Qualifications
  • Education: Bachelor's degree in business, healthcare administration, or a related field; equivalent, relevant experience will be considered in lieu of education requirement.
  • Experience: 15+ years of experience in the healthcare industry.
  • Leadership Experience: 5+ years of recent senior leadership experience.
  • Contract Negotiation: 5+ years of experience in a client-facing contract negotiations role.
  • Provider Contracting: 5+ years of experience in provider contracting and network management.
  • Healthcare Knowledge: Strong understanding of healthcare and/or health plan operations and market economics (including health plan and provider financial models).
  • Regulatory Knowledge: Knowledge of operations and regulatory requirements for risk adjustable health plan products and quality measures related to value-based provider contracting.
  • Coding Knowledge: Knowledge of medical coding and diagnostic coding, and risk adjustment methodologies.
  • Provider Landscape: In-depth knowledge of the healthcare provider landscape across Wisconsin and Quartz networks is preferred.
  • Technical Skills: Proficient with Microsoft Office applications (Word, Excel, PowerPoint, Outlook, etc.).
  • Communication Skills: Well-developed communication skills (written and verbal) with a high degree of diplomacy and persuasiveness, along with the strong ability to collaborate and communicate with individuals and groups at all levels of the organization to cultivate strong working relationships.
  • Leadership Skills: Proven ability to build and lead a high-performing team through the expression of a clear vision of future goals and organizational expectations and inspiring others to achieve the goals.
  • Analytical Skills: Ability to quickly understand and evaluate complex financial structures and operational workflows, with a keen eye for detail and improvement.
What We Offer
  • Compensation and Benefits: Excellent benefit and compensation package.
  • Career Advancement: Opportunity for career advancement.
  • Professional Culture: Professional culture built upon the foundations of Respect, Responsibility, Relationships, and Resourcefulness.

Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity, Affirmative Action employer.