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CareSource · 12 hours ago

REMOTE - Network Development Director(Preferred Experience In Contracting And Managed Care) - R10938

United States

Full-time

Remote

Mid, Senior Level

$113K/yr - $198K/yr

5+ years exp

CareSource is a healthcare organization focused on providing access to quality care. They are seeking a Network Development Director responsible for provider contracting, network development, and ensuring compliance with regulatory requirements.

Health CareMedicalNon Profit

Comp. & Benefits

H1B Sponsor Likely

Responsibilities

Responsible for the development of networks in new markets

Will have significant interactions with third parties, contractors, and various companies engaged to develop networks in new markets

Responsible for provider recruitment of states, geographic regions, or markets as defined in the corporate strategic plans

Develop a Contracting Strategy on an as needed basis for the various targeted markets

Develop the key metrics to ensure a high level of network adequacy

Responsible for robust competitor and provider competitive analysis and the creation of other information to formulate a business decision related to the provider network

Compile quarterly and annual statistics

Responsible for the effective integration of new providers into the Network Operations infrastructure

Ensure that the provider setup for new markets or regions is consistent with the Departmental standards

Provide oversight of provider contracting activities when completed by contractors or other individuals or entities working on behalf of the Health Plan

Responsible for aggressive recruitment programs including recruitment materials and development and facilitation of quarterly reports

Provide formal feedback, documentation, and resolution of areas for improvement and monitor sustained improvement

Review audits of all performance from a productivity, performance, and quality perspective; address issues as identified

Implement a process in conjunction with other departmental Directors to ensure an effective approach to on-boarding new providers

Ensure the network complies with all regulatory requirements as well as with all company-mandated policies and procedures

Ensure provider network is adequate, cost effective, competitive, stable and meets the corporate and regulatory access requirements

Interact with the Finance Department in terms of pricing for provider contracts

Chair or co-Chair operational committees that relate to the contracting process

Participate in training sessions for providers and staff as appropriate

Implement performance improvement initiatives to improve Provider Satisfaction Scores incrementally on an annual basis

Perform any other job duties as requested

Qualification

Contract negotiationManaged care experienceNetwork managementStrategic managementData analysisLeadership skillsTraining skillsCommunication skillsAttention to detailTime managementProblem solving

Required

Bachelor's degree or equivalent in health-related field

Minimum 5 years management experience required

Minimum of 3 years contract negotiation experience required

Intermediate computer skills

Proficient in Microsoft Word, Outlook, and Excel

Knowledge of Network Management Processes & Services

Ability to manage and prioritize multiple tasks, promote teamwork and fact-based decision making

Communication skills

Ability to work independently and within a team environment

Attention to detail

Familiarity of the healthcare field

Critical listening and thinking skills

Training/teaching skills

Strategic management skills

Proper grammar usage

Time management skills

Proper phone etiquette

Decision making/problem solving skills

Leadership experience and skills

Resiliency in a changing environment

Employment in this position is conditional pending successful clearance of a driver's license record check

Influenza vaccination is a requirement of this position

A valid driver's license, car and insurance are necessary for work related travel

Preferred

Master's Degree or equivalent preferred

Managed care experience highly preferred

Benefits

Bonus tied to company and individual performance

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 (9)

2024 (39)

2023 (35)

2022 (22)

2021 (37)

2020 (28)