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Curative · 3 weeks ago

Director, Network Development (Healthcare)

Austin, TX

Full-time

Onsite

Senior Level, Lead/Staff

$150K/yr - $175K/yr

10+ years exp

Curative is building the future of health insurance with a first-of-its-kind employer-based plan designed to remove financial barriers and make care truly accessible. The Director Network Development Senior is a leader responsible for providing strategic leadership and oversight for network management, implementing network strategies, managing provider contracts, and ensuring high-quality provider relationships.

Health CareHealth DiagnosticsHealth InsuranceMedicalMedical DevicePersonal Health

Responsibilities

Manages contract negotiations with Major Health Systems, large physician groups in Texas and Oklahoma; national ancillary providers; conducting several negotiations simultaneously to meet growth demands

Deep understanding and experience with all complex contracts to ensure contract terms and conditions address the coding structures which are most impacted by negotiations

People manager and mentor. Will directly manage a team of negotiators

Able to work in a fast-paced environment with high volume contracting requirements for the role. (Position will be responsible for completing a minimum number of contracts per month as well as managing the team to do the same.)

Proactively build relationships that nurture provider partnerships to support the local market strategy

Initiates, nurtures, and maintains effective channels of communication with matrix partners including, but not limited to, Claims, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing

Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain competitive position and identify and manage initiatives that improve total medical cost and quality; including renegotiation of existing agreements

Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms

Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review analysis of reports as part of negotiation and reimbursement modeling activities

Assists in resolving elevated provider service complaints, researching and negotiating with internal/external partners/customers to resolve complex and/or escalated issues

Manages key provider relationships and is accountable for critical interface with providers and business staff

Coach and support newer team members on strategies and approaches to successful negotiations

Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape

Partner with Regulatory Affairs to ensure all network filings are timely and accurate; including participation with Compliance to ensure adherence to established guidelines supporting Mental Health Parity

This position assumes and performs other duties as assigned

Qualification

Contract negotiationProvider relationship managementFinancial acumenHealthcare contracting experiencePeople managementCustomer centricityGoogle productsProblem solvingDecision-makingInterpersonal skills

Required

Superior problem solving, decision-making, negotiating skills, contract language and financial acumen

In depth understanding of the contract cycle from contractual negotiation to credentialing and contract terms load

Hospital / Health Systems, Large Physician Groups and Ancillary provider contracting and negotiations

Experience in developing and managing key provider relationships, including senior executives

Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners

Team player with proven ability to develop strong working relationships within a fast-paced, high-volume organization

Customer centric and interpersonal skills are required

5+ years of being a people manager

Experience with Google products

Bachelor's degree (B. A.) from four-year college or university; or equivalent experience in related field

7+ years of experience with health plan or provider organizations

A minimum of 10 years professional work experience in provider negotiating and contracting with Texas and Oklahoma hospitals and/or affiliated large group contracting experience

Must have current hospital and/or large group and ancillary contracting experience in appropriate state

Existing relationships with major health systems and large physician groups in Texas and Oklahoma is required