Executive Director, Network Management – Texas Network Contracting

This is a fully remote position, open to applicants in Texas.

📋 Description

• Design and oversee provider contracting and servicing strategies, along with value-based care programs for a designated region.

• Responsible for the upkeep, development, negotiation, and successful execution of provider network participation agreements. Ensure adequate network coverage for various locations.

• Manage the contracting operations for professional providers and hospitals across group, government, and retail programs.

• Attain a competitive edge in discounts and access through effective contract negotiations and relationship management.

• Formulate strategies, draft agreements, and negotiate contracts for newly recognized provider categories.

• Supervise the necessary analysis and reporting to develop payment strategies and implement corrective actions when required.

• Responsible for resolving issues and contractual disputes.

• Ensure that staff meet or surpass goals, objectives, and initiatives. Make certain that staff members are adequately trained, positions are filled, and employees are kept informed of changes.

• Accountable for budget management, operational reporting, and financial reporting.

• Foster effective communication and support for regional counterparts in sales, marketing, and account management.

• Interact and communicate professionally and effectively with colleagues, management, customers, and others.

• Adhere to HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and all relevant corporate and departmental guidelines.

• Maintain complete confidentiality regarding company-related matters.

• Keep the Vice President of Network Management informed about developments in assigned responsibilities and undertake special projects as needed or requested.

⛳️ Requirements

• Bachelor's degree and 7 years of experience in health care/insurance administration, hospital/health care contracting, and hospital/physician relations.

• 5 years of management experience at the director level, including involvement in or responsibility for developing strategies and initiatives.

• Understanding of hospital and provider reimbursement strategies and policies.

• Strong verbal and written communication skills, including interpersonal abilities to represent the company to external entities, negotiate contracts, resolve issues, and prepare presentations for executives and employees.

• Leadership capabilities, team-oriented, and adept at building relationships.

• Experience in a fast-paced environment and meeting deadlines.

• Demonstrated accuracy and sound judgment regarding financial matters such as contract performance and impact.

• Negotiation expertise, with experience in negotiating large and complex hospital and physician group contracts.

• Willingness and ability to travel.

🏝️ Benefits

• Health insurance

• 401(k) savings plan

• Pension plan

• Paid time off

• Paid parental leave

• Disability insurance

• Supplemental life insurance

• Employee assistance program

• Paid holidays

• Tuition reimbursement

• Other incentives