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VP, Provider Performance | Network Development & Contracting

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St Louis, MO
Job Type
Direct Hire
Aug 17, 2018
Job ID
Provider Performance | Network Development & Contracting -  St Louis,  Missouri

Incredible growth and market expansion has created the need for strategic leadership in provider contracting and network development across all product lines.  We need someone who understands quality and outcomes and nurturing collaborative relationships with key providers in the market by sharing data and best practices.

  This is THE opportunity to bring INNOVATION to a leading healthcare enterprise with an exceptional leadership team.

VERY willing to consider relocating talented professional who brings NEW ideas to this company.

 VP will lead all aspects of provider network strategy including access analysis and network operations.  Engage with other decision makers for analysis related to reimbursement and unit cost management.
· Oversee network development staff and external consultants in the development of provider networks across expansion markets.
· Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. Provide leadership in evaluating opportunities to expand or change the network to meet Company goals.
· Manage budgeting and forecasting initiatives for product lines to networks 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.
· Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
· Collaborate with senior leadership on key provider relations and strategy.
· Ensure provider compliance with ADA requirements, accessibility and accommodations

- Bachelor's degree or equivalent experience 

-10+ years of current experience in managed care network development and provider relations/contracting management in a managed care environment.
-Previous management experience including responsibility for expanding and developing staff.

MBA or MHA degree