What are the responsibilities and job description for the Strategic Network Development Director position at Superior HealthPlan?
Company Overview
SUPERIOR HEALTHPLAN is a leading health insurance company that transforms the lives of its members. As a strategic network development director on our team, you will have the opportunity to make a significant impact on the health and well-being of millions of people.
Salary Range
$182,100.00 - $345,600.00 per year
About the Role
We are seeking an experienced provider network strategy leader to direct our provider network and contracting activities. In this role, you will be responsible for leading all aspects of provider network strategy, including access analysis, network operations, and supporting decision makers with analysis related to reimbursement and unit cost management.
- You will establish the department's strategic vision, objectives, and policies and procedures.
- You will develop, implement, and maintain production and quality standards for the Contracting department.
- You will oversee network development staff and external consultants in the development of provider networks across expansion markets.
- You will perform periodic analyses of the provider network from a cost, coverage, and growth perspective. You will provide leadership in evaluating opportunities to expand or change the network to meet Company goals.
- You will manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.
- You will oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.
- You will conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy.
- You will support market expansion and M&A activities by leading provider contract analysis related to due diligence.
- You will assist health plan CEO and/or COO vendors in key provider relations and strategy.
- You will be able to travel.
Requirements
To be successful in this role, you will need:
- Bachelor's degree or equivalent experience in Business Administration, Healthcare Administration, or a related field. MBA or MHA degree preferred.
- 10 years of experience in managed care network development and provider relations/contracting management in a healthcare and/or managed care environment.
- Previous management experience, including responsibilities for hiring, training, assigning work, and managing performance of staff.
Preferred Experience
Contracting for Medicaid, Medicare, Marketplace, VBC, and Risk Agreements in Medicare.
Benefits
Centene offers a comprehensive benefits package, including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field, or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Equal Opportunity Employer
SUPERIOR HEALTHPLAN is an equal opportunity employer that is committed to diversity and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Salary : $182,100 - $345,600
