Job Summary :
The Vice President, National Network Development is responsible for leading network expansion and implementation activities for new markets and products that are targeted for business development procurements, new product offerings and plan integrations.
Essential Functions
- Responsible for provider contracting including hospital, physician, ancillary, supplemental, non-traditional provider, LTSS and SDOH provider / partner contracting to facilitate optimal member access, successful business growth initiatives and sound plan financial performance as it relates to unit pricing in targeted states, regions, or markets
- Responsible for the development of networks in new markets or for new programs
- Responsible for gaining provider network participation commitments that can be included in RFP responses; may be required to complete provider network builds prior to RFP
- Develop a contracting strategy for various markets targeted for business development opportunities
- Effectively uses LOIs, LOAs contracts or other agreements as necessary through various stages of a procurement process
- Can drive outcomes to successfully meet network requirements for purposes of developing an RFP, meeting readiness review compliance, or other business deliverable as indicated
- Responsible for building compliant and saleable networks for Medicaid, Medicare and Marketplace for target markets in the business development pipeline
- Ensure a high level of network adequacy and compliance for readiness when a new market is awarded
- Ensure that the provider setup for new markets or regions is consistent with the CareSource standards
- Collaborate with Market Network team to transition management of the network to the Market once the Market goes live
- Willing to travel to achieve results in targeted markets and programs
- Performs any other job related duties as requested.
Education and Experience
Bachelor's degree in a business-related field requiredMaster's degree preferredEquivalent years of relevant work experience may be accepted in lieu of required educationSeven (7) years in provider network management, with at least five (5) years in leadership requiredManaged Medicaid, Medicare Advantage, DSNP and Marketplace experience preferredCompetencies, Knowledge and Skills
Proficient in Microsoft Office toolsStrong time management and prioritization skills, with the ability to manage multiple network builds simultaneouslyStrategic and forward thinking; ability to lead within a matrixed organizationProven ability to negotiate with and develop strong relationships with hospitals and providersAbility to design and deploy innovative approaches to provider reimbursementAbility to manage a large, diverse staffStrong leadership and management skillsStrong communication skillsAbility to work independently and within a team environmentAttention to detail and follow throughExpertise within healthcare fieldCritical listening and thinking skillsTraining / teaching skillsCustomer service orientedDecision making / problem solving skillsLicensure and Certification
Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminatedTo help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working Conditions
General office environment; may be required to sit or stand for extended periods of timeUp to 50% (Frequent) travel based on the needs of the department may be requiredCompensation Range :
$150,000 - $300,000. CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type : Salary
Competencies :
Fostering a Collaborative Workplace CultureCultivate PartnershipsDevelop Self and OthersDrive ExecutionEnergize and Inspire the OrganizationInfluence OthersPursue Personal ExcellenceUnderstand the BusinessThis job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
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