Responsible for being the single focal point for network management contracting activities at the enterprise level
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Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com
The Vice President of Provider Network Management is responsible for being the single focal point for network management contracting activities at the enterprise level. Ensures that we provide compliant and high-performing networks that meet access and service requirements for our members in all markets. All network leadership/staff report into Director(s) Market Network Management, who report into this VP, Provider Network Management position.
Responsibilities, at a minimum, include:
- Working with the Director, Network Management Growth Markets and the Director, Network Strategy, sets overall direction in the development of strategy and planning for all new market development activities. Responsible for all staff and functions within the Network New Business Development Department that contract within the new markets.
- Working with the Director, National Contracts, establishes strategy for working with multi-market provider organizations.
- Working with the Director(s) Market Network Management, establishes and maintains operational controls over contract renewals and health value optimization (HVO) targets.
- Establishes contract templates that are consistent with plan requirements, taking into account corporate/legal direction.
- Works with the VP, Provider Performance and the VP, Network Pricing to ensure that we develop networks that lead to optimization, while focusing on excellent quality and outcomes for our members.
- Accountable for overarching provider relationship management by implementing initiatives created through Provider Network Strategy.
- Accountable for productivity and management of the network management resources.
- Bachelor's degree in Business or health related discipline or equivalent business experience. Graduate degree preferred.
- Fifteen plus years provider network experience required.
- Prior leadership experience required with demonstrated success in managing and motivating a large team.
- Experience working in a large highly matrixed organization, with proven ability to develop internal enterprise relations, and external relationships with the medical community.
- Previous experience evaluating and developing network operational strategy and performance in a metrics-based environment..
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