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AmeriHealth Caritas · 1 day ago

Corporate Director of Network Adequacy

United States

Full-time

Remote

Director/Executive

10+ years exp

AmeriHealth Caritas is seeking a Corporate Director of Network Adequacy to lead the strategic integration and utilization of provider network adequacy data. This role involves overseeing a team to ensure compliance with geographic access standards and collaborating with various departments to optimize network performance.

Health CareInformation Technology

H1B Sponsor Likely

Responsibilities

Develop and execute business intelligence requirements to manage and validate provider information and ensure data integrity in Facets and Market Data Libraries across the contracting continuum Request for Proposal (RFPs), new markets, new products, market expansions, and re-procurements)

Design, implement, and document business and reporting processes, programs, policies, and procedures to support transition to market plan operations and meet regulatory reporting requirements

Model and drive network development opportunities throughout the contracting lifecycle to address network gaps, implement remediation plans, and support alternative delivery systems while ensuring regulatory and contractual compliance

Interpret and apply access and adequacy standards for growth and existing markets in compliance with state and federal contracts, configuration requirements, and reporting obligations

Analyze and interpret network adequacy data by collecting, sorting, and evaluating information, blending business and network expertise with strong analytical skills

Collaborate across functional areas to identify issues, communicate with executives, and develop strategic action plans related to adequacy, geographic access, network development, and business intelligence. Key partners include Network Management, Provider Enrollment, Market Entry, New Business Development/Growth Markets, and IS stakeholders

Qualification

Healthcare networks experienceBusiness intelligenceData analysisRegulatory complianceMatrixed environment experienceLeadership skillsCommunication skillsCollaboration skills

Required

Bachelor's degree required

10 plus years of relevant experience in healthcare networks, analytics, business intelligence, market development, or related fields

Proven ability to lead teams, manage complex datasets, and interpret regulatory requirements

Excellent written and oral presentation/communication skills

Experience working in matrixed environments

Effective leadership and analytical skills

Ability to work collaboratively with internal and external stakeholders

Preferred

Master's degree preferred

Company

AmeriHealth Caritas

Glassdoor3.4

AmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill.

Founded in 1982

Philadelphia, Pennsylvania, USA

10001+ employees

http://www.amerihealthcaritas.com

H1B Sponsorship

AmeriHealth Caritas 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 (18)

2024 (17)

2023 (12)

2022 (14)

2021 (4)

2020 (11)