The VP, Commercial Network Business leader will be responsible for developing and implementing the Network strategy for the Commercial segment and driving results.
S/he will be accountable for achieving all targets and scorable action items (SAIs), as well as achieving P-Model targets and driving pricing strategies. This role serves as the key contact point with Market leaders (e.g, SVP, Markets, Territory leaders and Market Presidents) and coordinates with peers across the business. S/he is responsible for setting the strategic direction for network creation and developing future focused enterprise wide contracting strategies optimizing our national network products to deliver profitable growth. This includes but is not limited to, development of contract strategy, negotiation, analysis and administration of all fee-for-service and risk/incentive-based payor contracts at a national level. Additionally, this leader will be responsible for the Network Access Business, inclusive of contract execution and provider relationship management for our rental networks (e.g., First Health).
S/he will be responsible for developing the key messages and talk points to the external community and represent the Company at key meetings, conferences and negotiations. Responsible for over 1.6 million providers with an annual spend of $65 billion.
As the National leader, s/he will develop quality, cost competitive networks aligning Commercial products to drive profitable growth. S/he will work across the organization and with Shared Services to create leading edge measurement tracking and root cause analysis mitigating risk exposure and driving enhanced performance. S/he will lead the organization in driving the value-based strategy and innovation of payor contracts that advances efforts to move toward more value-based reimbursement while ensuring the financial integrity of the contracts and minimizing risk. This leader will work closely with Markets leaders to successfully drive total cost of care, quality and provider selection initiatives achieving measurable results.
The leader will foster tighter alignment, integration and shared goals with the Markets organization and our national Network Strategy and Provider Experience organization. Additionally, s/he will manage a diverse team of highly skilled network managers, contract negotiators and other professionals.
This role may be REMOTE.
Responsibilities include but are not limited to oversight and leadership of the following:
Commercial Network Management
- Development of Network strategy and provider selection
- Accountable for achieving targets, SAIs, total cost of care
- P-Models and pricing strategies
- Serves as single point of contact for Market leadership
- Vendor Rental Networks management
Network Access business
- Contract execution
- Provider relationship management
Institutes of Quality and Institutes of Excellence
The role reports to the Senior Vice President of Network Strategy and Provider Experience.
- Approximately15 years of healthcare experience including contracting, medical economics and field or national network experience.
- Experience contracting with providers and hospital systems.
- Strong presentation and communication skills; ability to consult as well as negotiate
- Strong analytical skills including root cause analysis
- Skilled at collaborating and working across a complex matrixed organization
Bachelor's degree or equivalent experience
Percent of Travel Required
0 - 10%