Alignment Health
health care
AVP,Contracting&NetworkManagement
Neural analysis suggests this role is
optimal for Senior candidates.
“AVP, Contracting & Network Management at Alignment Health. Skills: network management, contracting, negotiation, financial modeling. Create, translate and execute strategies for optimal network. Lead, manage, negotiate and implement provider network contracts”
What You'll Achieve.
create health care delivery systems that support enhanced marketability, member and provider satisfaction, and company’s overall success; produce desired growth, financial and operational outcomes; maximize successful new market launches and implementations; support network performance opportunities and development activities; ensure overall success of the markets; Meets and exceeds budget and operating goals; Establishes department metrics and sets clear expectations for staff and market
Industry & Context.
analytical and critical thinking skills; Direct others to resolve highly complex or unusual business issues
Ability to travel nationally 50% of the time, Available for evenings/weekends and extended work hours as needed, Physical demands: regularly required to talk or hear, stand, walk, sit, use hand to finger, handle or feel objects, tools, or and reach with hands and arms, Frequently lifts and/or moves up to 10 pounds, Specific vision abilities: close vision and the ability to adjust focus
What They're Looking For.
Must Have
10 years of experience in managed care or health care field, understanding of reimbursement methodologies, contract language, negotiation strategies, financial modeling and analysis, managed care, Medicare Advantage, network management and contracting expertise, analytical and critical thinking skills, ability to develop and implement network strategies, Excellent knowledge of managed care, various reimbursement methodologies, contracting language knowledge of managed care, Demonstrated people leadership skills, Excellent oral, written and presentation skills, ability to convey complex or technical information, Proven ability to foster collaboration, value others perspective, gain support and buy-in for organization proposal, Excellent Microsoft Office skills, Word, Excel, Experience with delegated and non-delegated providers, Experience managing medical cost through network strategies, Ability to travel nationally 50% of the time, Available for evenings/weekends and extended work hours as needed, Outstanding organizational and project management abilities, Excellent verbal/written skilled in facilitation and presentation
Nice to Have
MBA
What You'll Do.
translate and execute strategies for optimal network
negotiate and implement provider network contracts
Develop strategy for innovative ways to create value
Utilize financial models to develop and execute strategy
Provide network contracting analysis and contract language expertise
Leverage competitive landscape to assess and design network
Work with multidisciplinary team to produce outcomes
Develop relationships with key company stakeholders
Work with providers and delivery systems in new markets
Direct others to resolve complex business issues
evaluate and implement network performance opportunities
Work closely with Regional Medical Officers
Meet and exceed budget and operating goals
Establish department metrics and set clear expectations
Collaborate and support training and onboarding of new leaders
How You'll Work.
Team & Collaboration
Work closely with the national business development team; Work closely with regional and corporate executives and operational teams; Work with multidisciplinary team; Develop relationships with key company stakeholders, physician leaders and delivery systems; Work with providers and delivery systems in new and emerging markets; Work closely with Regional Medical Officers, Market Presidents and other department heads; Collaborate and support training and onboarding of new market network leaders
Communication Scope
Excellent oral, written and presentation skills; ability to convey complex or technical information; Excellent verbal/written skilled in facilitation and presentation
Process & Methodology
Outstanding organizational and project management abilities
Full Job Description
Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together. Reporting to National SVP, Network Strategy & Market Development, the AVP, Contracting & Network Management is responsible for the development of network strategies and leveraging implementation of network development and network management plans to create health care delivery systems that support enhanced marketability, member and provider satisfaction, and company’s overall success. The candidate will work closely with the national business development team, as well as regional and corporate executives and operational teams. _General Duties/Responsibilities (May include but are not limited to):_ * Creates, translates and execute strategies for optimal network and network development in established and new markets. * In conformance with corporate standards, accountable to lead, manage, negotiate and implement all types of provider network contracts, including but not limited to IPAs/Medical Groups, hospitals, direct network physicians, ancillary providers and supplemental vendors. * Develops strategy for innovative ways to create value from next gen contracting, network design and care models for government sponsored populations. * Utilizes financial models to develop and execute strategy for all reimbursement models, including but not limited to capitation, per diems, case rates, value based arrangements and incentive programs to
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