Network Medical Executive

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

📋 Description

• Act as a physician leader to advance affordability, trend, and network performance goals in designated markets and provider partnerships.

• Leverage provider relationships, market insights, and performance metrics to pinpoint opportunities for enhancing cost efficiency, quality, utilization, access, and overall network effectiveness.

• Collaborate with provider organizations to tackle clinical and operational factors contributing to healthcare trends, unnecessary variations, and avoidable expenses.

• Assist in the implementation of evidence-based initiatives aimed at enhancing value, improving outcomes, and promoting effective site-of-care, specialty, and referral management strategies.

• Work together with analytics, actuarial, network, finance, and clinical teams to explore opportunities, outline interventions, and evaluate performance enhancements.

• Provide clinical leadership to address emerging affordability challenges, opportunities for provider performance improvement, and strategic network priorities.

• Build and sustain trusted executive-level relationships with health systems, physician organizations, specialty groups, and independent providers.

• Serve as a credible clinical advisor and strategic collaborator with provider leadership.

• Foster discussions regarding affordability opportunities, provider performance, value-based care, quality outcomes, and clinical collaboration.

• Collect provider insights and market intelligence to guide internal decision-making, escalation management, and strategic planning.

• Assist in resolving complex provider issues, escalations, and relationship opportunities.

• Support the growth, execution, and optimization of value-based care initiatives and provider performance programs.

• Encourage provider adoption of care delivery models and population health strategies.

• Identify obstacles to provider success and connect them with clinical, operational, and analytical resources.

• Offer clinical consultation and market insights for network strategy, provider partnerships, and contracting efforts.

• Aid in assessing provider organizations, market opportunities, strategic partnerships, and performance improvement initiatives.

• Contribute to efforts that enhance network competitiveness, provider collaboration, and clinical alignment.

• Participate in special projects, tools, resources, best practices, and operational consistency within Network & Provider Relations.

⛳️ Requirements

• MD or DO degree.

• Active, unrestricted medical license.

• Board certification in an ABMS-recognized specialty.

• At least 5 years of clinical practice experience.

• Minimum of 3 years in healthcare leadership, payer, network, provider relations, or value-based care roles.

• Capacity to influence physician leaders, provider executives, and cross-functional partners.

• In-depth understanding of healthcare economics, clinical quality, utilization, population health, and performance improvement.

• Outstanding communication, presentation, relationship-building, and executive presence skills.

• Ability to function effectively in a highly matrixed, fast-paced, and dynamic environment.

• Preferred experience in provider network management, contracting support, or provider performance strategy.

• Preferred experience in value-based care arrangements, quality improvement, or population health operations.

• Preferred experience in healthcare affordability initiatives, trend management, analytics, or financial performance improvement.

• MBA, MHA, MPH, or equivalent business experience or training preferred.

• Preferred experience leading cross-functional projects, peer learning forums, or team-based operating model initiatives.

• Reliable work-at-home internet connection via cable broadband or fiber optic service with at least 10Mbps download and 5Mbps upload speed.

🏝️ Benefits

• Eligibility for an annual bonus.

• Eligibility for a long-term incentive plan.

• Medical benefits.

• Vision benefits.

• Dental benefits.

• Well-being and behavioral health programs.

• 401(k) plan.

• Company-paid life insurance.

• Tuition reimbursement.

• A minimum of 18 days of paid time off annually.

• Paid holidays.

• Leaves of absence.

• Work-from-home arrangement.