VP, Provider Contracting | Network | Strategy

Location: Portland, OR
Job Type: Direct Hire
Degree: Bachelor;
Date: 11/27/2018
Job ID: 02632067
Job Description
VP, Provider Contracting | Network | Strategy

               OREGON - Portland |   Eugene 

       STRONG leadership team - GREAT relo & benefits.

Experienced strategist with exceptional relationship - building skills will direct the provider network and contracting activities across the OR market for multiple product lines.   Responsible for analysis, network operations and supporting decision makers with analysis related to reimbursement and unit cost management. Oversee the coordination and negotiation for the contracting department.
Develop, implement and maintain production and quality standards for the Contracting department.

Oversee network development staff and external consultants in the development of provider networks across expansion markets.

Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. Provide leadership in evaluating opportunities to expand or change the network to meet Company goals.

Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts.

Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.

Conduct periodic review of provider contracting rates to ensure strategic focus is on target with overall Company strategy.

Support market expansion and M&A activities by leading provider contract analysis related to due diligence.

- Bachelor's degree 

-10+ years of experience in managed care network development and provider relations/contracting management in an MCO, ACO or health plan. 

- Proven leadership experience including responsibilities for hiring, training, succession-planning.