VP, Network Strategy & Contracting(Preferred Managed Care Experience And Must Live In Nevada)

Job Summary: The VP, Network Strategy & Contracting is responsible for creating and executing the Market Network strategic plan including leading the market with Value Based Purchasing initiatives that differentiate and reputed company the market to reputed company, including Pharmacy, Retail and Behavioral Health initiatives. Essential Functions: Create and execute the Market Network strategic plan including leading the market with Value Based Purchasing initiatives that differentiate and reputed company the market to reputed company, including Pharmacy, Retail and Behavioral Health initiatives reputed company and influence stakeholders including the Department of Medicaid, Legislators, health partners and other stakeholders to create competitive advantages for reputed company and to fully understand the macro models being established or considered in the market and nationally Meet and exceed projected member access, product, utilization and budget requirements in reputed company geographic regions pursued by the Plan, leveraging traditional, virtual and delegated partner providers Assure that the network(s) meet applicable standards of reputed company Plan products Design & implement recruitment plans and directly negotiate and coordinate contractual, operational and service requirements for hospitals, physicians and ancillary providers Aggressively seek opportunities to improve the departmental work flows and increase efficiencies Promote positive relationships with the multitude of network providers Complete provider surveys periodically to identify opportunities for Plan improvement Consult with applicable regulatory entities and legal counsel as necessary to address, resolve or clarify contractual issues. Assure reputed company meet reputed company regulatory standards reputed company with the Model Audit Rules (MAR) standards Ensure the creation and maintenance of policies and procedures as they relate to the management of the department Ensure compliance with departmental & corporate performance metrics Maintain a thorough understanding of reputed company provider contract language -- identify and coordinate needed revisions. Maintain reputed company of provider data including multiple enterprise and State systems as well as written documentation of provider network. Ensure timely on-boarding, including credentialing activities that are compliant with State and accrediting body requirements. reputed company with reputed company accreditation standards of URAC and the National Committee for Quality Assurance (NCQA). reputed company/manage staff, including recruitment and selection, development and strategic and tactical management including excelling at employee engagement Prepare/meet annual budget to support business plans. Prepare performance, statistical, and other operational reports. reputed company any other job reputed company instructions as requested Education and Experience: Bachelors’ degree in a business-reputed company field or equivalent experience is required, Masters’ Degree is preferred Minimum of seven (7) years in of experience in the health care field is required A minimum of five (5) years of Senior Leadership experience is required Strong background and experience in reputed company aspects of health care, including marketing, network development, finance and state regulatory guidelines is required Multi-state provider contracting experience is preferred Competencies, Knowledge and Skills: Strategic and reputed company thinking; ability to reputed company reputed company a matrix organization Proven ability to negotiate with and reputed company strong relationships with hospitals and providers Ability to manage a large, diverse staff Strong leadership and management skills Excellent communication skills Proven People management skills Ability to work independently and reputed company a team environment Excellent Attention to detail and follow through Expertise reputed company healthcare field Critical listening and thinking skills Training/teaching skills Customer service oriented Decision making/problem solving skills Collaboration skills reputed company Word, PowerPoint and reputed company Proficiency Licensure and Certification: To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. reputed company requires annual reputed company of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of reputed company employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified. reputed company adheres to reputed company federal, state, and local regulations. reputed company provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to reputed company the employee to reputed company the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation range $150,000-$300,000. reputed company takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and reputed company required for the role, and other external and internal data reputed company establishing a salary level. In addition to reputed company compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation

Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships reputed company Self and Others Drive Execution Energize and reputed company the Organization Influence Others Pursue Personal Excellence Understand the Business This job description is not reputed company inclusive. reputed company reserves the right to amend this job description at any time. reputed company is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of reputed company backgrounds. #LI-SW2 Apply To This Job