Provider Network Strategy Manager
Accountable for supporting the efforts towards the successful development and implementation of corporate-wide value based strategies, network performance and operational efficiencies. Responsible for identifying opportunities to reduce cost, improve quality and enhance the member experience of care while at the same time monitoring the results of these efforts.
Essential Functions
- Participates with the Vice President of Provider Network developing and implementing Priority Health's philosophy, mission, goals, and objectives that align with the nationwide network expansion and operation support. Ensures department policies, programs, and plans are consistent with and support Priority Health's core values and mission.
- Works with department leaders to identify, recommend, develop, and update departmental strategy and goals to support Priority Health philosophy and longer-term strategic intent. Develops and achieves business goals that include establishing and maintaining operational standards.
- Work cross-functionally with other individuals to remove barriers impeding department goals and targets and to identify opportunities for improvement and facilitate problem resolution.
- Cultivate and maintain productive relationships with key hospitals, physician medical groups, organized provider organizations and ancillary vendors. Oversee negotiation strategies and lead or participate in negotiations with key providers. Serve in leadership positions on key community boards of directors and statewide professional / industry organizations.
- Provide advice / guidance / recommendations to Vice President and business partners regarding health care costs, cost savings opportunities, best practices, provider performance issues, provider compensation, and network expansion.
- Lead, motivate and manage the team of professionals responsible for the span of control defined for this position.
- Collaborate with stakeholders across the organization to ensure successful outcomes for Provider Network initiatives and strategies.
- Responsible for monitoring budget and preparing annual fiscal budget with the Vice President of Provider Network.
Qualifications
Required Bachelor's Degree Finance, Accounting, or related fieldPreferred Master's Degree MBA or advanced degree in Finance7 years of relevant experience related health care experience. Required5 years of relevant experience in a leadership role with a demonstrated ability to lead teams, manage budgets, and drive strategic initiatives. Required5 years of relevant experience people management of consulting leadership. RequiredExperience in provider network development and management. RequiredProven track record of achieving revenue targets and demonstrated ability to think strategically with a thorough understanding of strategic development. RequiredExperience working in an organization of size and complexity. RequiredPhysical Demands
Pallet to Waist (6" from floor) >5 lbs : Seldom up to 10 lbs
Waist to Waist >5 lbs : Seldom up to 10 lbs
Waist to Chest (below shoulder) >5 lbs : Seldom up to 10 lbs
Waist to Overhead >5 lbs : Seldom up to 10 lbs
Bilateral Carry >5 lbs : Seldom up to 10 lbs
Unilateral Carry >5 lbs : Seldom up to 10 lbs
Pushing Force >5 lbs : Seldom up to 10 lbs
Pulling Force >5 lbs : Seldom up to 10 lbs
Sitting : FrequentlyStanding : OccasionallyWalking : OccasionallyForward Bend - Standing : SeldomForward Bend - Sitting : OccasionallyTrunk Rotation - Standing : SeldomTrunk Rotation - Sitting : OccasionallyReach - Above Shoulder : SeldomReach - at Shoulder or Below : SeldomHandling : OccasionallyForceful Grip >5 lbs : Seldom
Forceful Pinch >2 lbs : Seldom
Finger / Hand Dexterity : Frequently