Director Network Manager

Description:

The Director Network Management-Colorado is responsible for network development and provider reimbursement for the Colorado Health Services Area. This leader oversees a team, managing a high-volume, complex portfolio spanning provider contracting, network adequacy, and performance management including regulatory scrutiny, network adequacy standards, and affordability initiatives.

How You Will Make In Impact
 

• Oversees contracting and maintenance of all facilities including hospitals, surgery centers, etc.
• Oversees the development, maintenance and reconciliation of physician risk contracts and capitated arrangement.
• Attracts, develops and manages key contracting and servicing staff.
• Develops innovative ways to maintain a cost effective network with adequate access and positive working relationships with providers.
• Hires, trains, coaches, counsels, and evaluates performance of direct reports.
   

Minimum Qualifications
 

• Requires a BS/BA degree in business administration or related healthcare field and a minimum of 8 years healthcare operations, finance, underwriting, actuary, network development and sales experience; or any combination of education and experience, which would provide an equivalent background.
   

Preferred Skills, Capabilities And Experiences
 

• Strongly preferred CPA or MBA degree.
• Strong leadership for effective issue escalation and stakeholder coordination, particularly with regulators and key provider systems.
• Strong analytical and relationship building skills.
• Previous provider contracting experience, preferably with large health systems.