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CareSource · 2 weeks ago

REMOTE - Vice President, National Network Development(Preferred Experience In Managed Care & Network Development) - R10868

United States

Full-time

Remote

Mid, Senior Level

$150K/yr - $300K/yr

7+ years exp

CareSource is seeking a Vice President for National Network Development to lead network expansion and implementation activities for new markets and products. The role involves provider contracting, network development, and ensuring compliance and adequacy for Medicaid, Medicare, and Marketplace networks.

Health CareMedicalNon Profit

Comp. & Benefits

H1B Sponsor Likely

Responsibilities

Responsible for provider contracting including hospital, physician, ancillary, supplemental, 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 markets or for new programs

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 Medicaid, 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

Willing to travel to achieve results in targeted markets and programs

Performs any other job related duties as requested

Qualification

Provider network managementContracting strategy developmentHealthcare expertiseMicrosoft Office proficiencyLeadership skillsCustomer service orientationTime managementNegotiation skillsCommunication skillsProblem solving

Required

Bachelor's degree in a business-related field required

Seven (7) years in provider network management, with at least five (5) years in leadership required

Must have valid driver's license, vehicle and verifiable insurance

Influenza vaccination is a requirement of this position

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

Preferred

Master's degree preferred

Managed Medicaid, Medicare Advantage, DSNP and Marketplace experience preferred

Benefits

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.

Company

CareSource

Glassdoor3.8

CareSource provides managed care services to Medicaid beneficiaries.

Founded in 1989

Dayton, Ohio, USA

1001-5000 employees

https://www.caresource.com/

H1B Sponsorship

CareSource has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (30)

2024 (39)

2023 (35)

2022 (21)

2021 (37)

2020 (28)