Job Description

Location: Health Choice Management Co.
Posted Date: 2/12/2020

Health Choice is dedicated to improving the health and well-being of the people and communities we serve.

Health Choice believes in a personal approach to health care right in your community. We built our health care plan around you. Our goal is to give you quality health care, programs, and services to support you on your path to wellness.

Health Choice provides exceptional customer service and culturally competent care through:

  • Compassionate and responsive member services team
  • Collaboration with community physicians to help members get the health care they need.
  • Providing culturally competent health care, including extensive translation and interpretation services
  • Health programs to help members and their families stay healthy

Position Purpose: The Senior Director of Network Services is directly responsible for developing, implementing, and leading a strategic approach to building and sustaining a robust provider network across all lines of business. Engage executive leadership in driving and prioritizing proactive initiatives that support key business objectives and drive business development opportunities.

  • Aggressively pursue opportunities to engage the provider community and stakeholders in the identification and development of quality initiatives, and innovative reimbursement models
  • Identify and advance partnership opportunities, keeping executive leadership informed of community activities and competitive approaches
  • Draft, disseminate, summarize, and analyze physician/provider data including profiles, physician scorecards, member profiles, clinical alerts systems and other key evidence-based decision support tools
  • Work in collaboration with department directors to identify potential challenges and opportunities, and work to develop consensus approaches toward improving the overall delivery system
  • Work with internal subject matter leads and executive leadership including compliance and marketing divisions to ensure consistency and coordinated engagement with the provider community
  • Direct Supervision of all department staff while providing leadership and growth of staff through planned development and coaching
  • Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. Provide guidance in evaluating opportunities to expand or change the network to meet Company goals
  • Routine, proactive and meaningful interaction with finance, medical management, operations and sales to ensure a competitive network is in place, and optimal terms and/or provisions are negotiated into contract development/updates, and implemented as intended
  • Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts
  • Valid Arizona Driver’s license required as travel is required
  • Approximately 40% travel within the state of Arizona

Education / Experience / Other Requirements

Education:

  • Bachelor’s Degree in business administration, public health, public administration, health care administration, management, finance, or related field. Master’s Degree preferred

Years of Experience:

  • 5+ years of experience in managed care network development and provider relations/contracting management in a health care and/or managed care environment
  • Previous management experience including responsibilities for hiring, training, assigning work, and managing performance of staff

Specialized Knowledge:

  • Experience with Value Based Purchasing
  • Expertise in Healthcare Network Contracting, Payment and Management
  • Experience and Knowledge of General Health Plan Operations Including Care Management
  • Experience with Network Operational Systems and Processes
  • Significant Experience Using Analytics to Measure and Improve Provider and Health Plan Performance
  • Advanced Knowledge of Provider Cost, Utilization and Quality Measurement
  • Experience Leading Development of Proactive and Effective Provider Relations
  • Experience with Healthcare Network Building and Management
  • Experience Building and Managing Teams
  • Comfortable Managing Regional Teams and Processes
  • Track Record of Improving Processes, Teams and Performance
  • Strategic and Critical Thinking Skills
  • Problem Solving/Analysis
  • Communication Proficiency
  • Strong Presentation Skills
  • Experience Collaborating with Teams, Vendors and Resources
  • Budgeting and Financial Management
  • Decision Making Abilities
  • Results Driven and Client Focused
  • Initiative and Proven Organization Skills
  • Proactive Problem-Solver Focused on Quality Improvement

Position located in Phoenix, Arizona

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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