Job Description
Job Summary:
The Vice President, Network Strategy & Development is responsible for developing and leading all aspects of network development strategy activities in new and expansion markets that are targeted for business development and growth procurements.
Essential Functions:
Responsible for provider contracting including hospital, physician, ancillary, non-traditional provider, LTSS and SDOH provider / partner contracting to facilitate optimal member access, successful business growth initiatives and sound plan financial performance as it relates to unit pricing in targeted states, regions, or markets
Responsible for the development of networks in new and expansion markets or for new programs (e.g. DSNP; LTSS; and HCBS waiver population managed care expansion)
Responsible for gaining provider network participation commitments that can be included in RFP responses; may be required to complete provider network builds prior to RFP
Develop a contracting strategy for various markets targeted for business development opportunities
Effectively uses LOIs, LOAs contracts or other agreements as necessary through various stages of a procurement process
Can drive outcomes to successfully meet network requirements for purposes of developing an RFP, meeting readiness review compliance, or other business deliverable as indicated
Responsible for building compliant and saleable networks for Medicare and Marketplace for target markets in the business development pipeline
Ensure a high level of network adequacy and compliance for readiness when a new market is awarded
Ensure that the provider setup for new markets or regions is consistent with the CareSource standards
Collaborate with Market Network team to transition management of the network to the Market once the Market goes live
Responsible for national ancillary strategy and contracting team and ensuring team drives execution of national ancillary provider service model
Responsible for supplemental vendor network strategy and vendor management team that drives our national vendor business strategies and operations
Oversee team of development directors and ensure areas of accountability are meeting performance and key operational metrics to drive organization success
Willing to travel extensively to achieve results in targeted markets and programs
Perform any other job duties as requested
Education and Experience:
Bachelors' degree in a business-related field or equivalent experience is required
Masters' Degree is preferred
Minimum of seven to ten (7-10) years in provider network development and vendor contracting / management, with at least five (5) years in leadership is required
Managed Medicaid, Medicare Advantage, DSNP and Marketplace experience is preferred
Competencies, Knowledge and Skills:
Proficient in Microsoft Office tools
Strong time management and prioritization skills, with the ability to manage multiple network builds simultaneously
Strategic and forward thinking; ability to lead within a matrixed organization
Proven ability to negotiate with and develop strong relationships with hospitals and providers
Ability to design and deploy innovative approaches to provider reimbursement
Ability to manage a large, diverse staff
Strong leadership and management skills
Strong communication skills
Ability to work independently and within a team environment
Attention to detail and follow through
Expertise within healthcare field
Critical listening and thinking skills
Training/teaching skills
Customer service oriented
Decision making/problem solving skills
Licensure and Certification:
Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check and verified insurance. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated.
To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.
Working Conditions:
General office environment; may be required to sit or stand for extended periods of time
50 - 75% travel may be required
Compensation Range:
$150,000 - $300,000. CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type:
Salary
Competencies:
- Fostering a Collaborative Workplace Culture
- Cultivate Partnerships
- Develop Self and Others
- Drive Execution
- Energize and Inspire the Organization
- Influence Others
- Pursue Personal Excellence
- Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
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CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law.
