Vice President Network Development & Contracting

Location: Saint Louis, MO
Job Type: Direct Hire
Salary: $150,000.00 - $225,000.00
Degree: Bachelor; Master;
Date: 7/12/2018
Job ID: 02610833
Job Description
Vice President Network Development & Contracting

Seeking a Change Agent motivated to get things done with a strong background in value-based contracting and knowledge of public policy for this leading healthcare enterprise!

Reporting directly to the SVP Operations, the VP Network Development & Contracting will Direct the provider network and contracting activities, Lead all aspects of provider network strategy including, access analysis,
network operations and support decision makers with analysis related to reimbursement and unit cost management and Oversee the coordination and negotiation of the contracting department.
  • Establish the department’s strategic vision, objectives, policies, and procedures. 
  • Develop, implement and maintain production and quality standards for the Contracting department.
  • Oversee network development staff and external consultants in the development of provider networks across expansion markets.
  • Perform periodic analyses of the provider network from a cost, coverage, and growth perspective.
  • Provide leadership in evaluating opportunities to expand or change the network to meet Company goals.
  • Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.
  • Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.
  • Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy.
  • Support market expansion and M&A activities by leading provider contract analysis related to due diligence.
  • Assist health plan CEO and/or COO vendors in key provider relations and strategy.
  • Ability to travel.

- Bachelor's degree or equivalent experience. Preferred: MBA or MHA degree

-10+ years of current experience in managed care network development and provider relations/contracting management in a managed care environment. 
-Previous management experience including responsibility for expanding and developing staff.

  • Value-Based Contracting
  • Hospital network contracting/re-contracting
  • Strong knowledge of data-driven decisions
  • Experience managing single case agreements 
License/Certification: Valid driver’s license.