AVP of Provider Contracting and Network Development
Work at Home
Our client is an established, employee benefits company headquartered in the Midwest, whose focus is on providing quality and affordable health care customized to meet the specific needs of their customers. They are now seeking an individual to become the AVP of Provider Contracting & Network Development to oversee all aspects of provider relationships, including credentialing and servicing.
- Direct provider network and contracting activities.
- Lead all aspects of provider network strategy, including access analysis and network operations, as well as supporting decision makers with analysis related to reimbursement and cost management.
- Oversee the coordination and negotiation for the contacting department.
- Develop, implement and maintain production and quality standards for the contracting department.
- Provide leadership in evaluating opportunities to expand or change the network to meet company goals.
- Manage budgeting and forecasting initiatives for product lines, inclusive of network 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.
- Assist health plan CEO and/or COO in key provider relations and strategy.
- 7+ years of managed care provider contracting and reimbursement experience
- In-depth knowledge of various reimbursement methodologies and contracting terms including risk contracting and value-based contracting
- 5+ years of management experience
- Proven contract negotiations skills and experience
- Bachelor’s degree in business, healthcare or a related field
+1 (312) 884-0448