Senior Network Development Executive

Sr Network Development ExecutiveAt Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders - internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!Job SummaryThis position is responsible for identifying and evaluating opportunities in support of network-based solutions by negotiating optimal reimbursement rates and drafting contracts for network and non-network providers to support commercial and government products. This activity will ensure patient access to the highest quality, cost-effective providers of healthcare services in accordance with applicable regulations and the Company's policies, practices, and procedures.In addition, this position is responsible for working with management in the aggressive execution of regional strategies based on market trends and client expectations, as well as continuous evaluation of assigned territory penetration and discounts. This role may support other areas such as Payment Integrity and Analytics-Based Services.Key ResponsibilitiesAssist management in the identification and development of contracting priorities for assigned territory to support Network Development provider contracting initiativesNegotiate provider contracts to support penetration and discount objectives relative to competitive market trends and client expectations through comprehensive, aggressive execution of region-specific contracting goalsFoster and maintain superior provider relationships, including management of the business relationship with large, complex providersRespond to provider questions, issues, and problems that have been appropriately escalated and produce a solutionConduct complex internal audits and reviews of existing provider relationships and supporting documentation to resolve internal or external inquiriesFunction as provider-specific expert by identifying, understanding, and documenting strategic business needs and market strategiesMaintain, and preferably exceed, contracting production and quality standards consistent with established regional goalsPrepare analyses, reports, and presentations by collecting, analyzing, and summarizing information and trendsMonitor, compare, and contrast market competitive information to develop and initiate growth strategies and assess network adequacy and marketabilityServe as mentor to less experienced Provider Contractors through ongoing instruction, coaching, modeling, and counselingWork with Sales and Account Management to respond to and anticipate access requirements and network-related performance guaranteesPartner with HCE to conduct financial analyses and monitoring of market trends to identify, develop, and implement competitive reimbursement strategiesCollaborate, coordinate, and communicate across disciplines and departmentsDevelop and maintain positive relationships at all levels within the organization and communicate provider needs to applicable process ownersEnsure compliance with established policies and procedures and regulatory requirements (including but not limited to HIPAA)Complete mandatory training requirements, including Human Resources, product orientation, and contracting tools and resourcesDemonstrate Company's Core Competencies and valuesPerform other duties as assignedCompensationThe salary range for this position is $84-110k annually. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.Job ScopeThe incumbent is recognized as a senior-level professional who applies comprehensive knowledge of principles, practices, and procedures to negotiate and maintain complex provider network contracts.This role operates independently with substantial latitude for discretion and decision-making and may be authorized to act outside standardized procedures. The incumbent may support less experienced Provider Contractors in resolving complex issues and serve as a liaison with other departments.This position does not have direct supervisory responsibilities but may provide project leadership or work direction to less experienced team members. Overnight travel may be required to meet with providers within assigned geographic areas and/or attend company-sponsored meetings and events. The incumbent must demonstrate expertise in developing, structuring, and negotiating complex financial rate arrangements and contract language, with a proven track record of successful negotiations requiring this level of skill and judgment.Job RequirementsMinimum Bachelor's Degree in related or applicable field, or HS Diploma (or GED) and four (4) years of experience related to network developmentMinimum 5 years of experience in provider contracting and network development, including contracting experience with physicians, physician groups, hospitals, and ancillary providers, or equivalent provider/payer experienceKnowledge of provider finance components including budgets, charge structures, reimbursement formulas, and healthcare financeKnowledge of provider organizations and operations applicable to assigned focus areaKnowledge of the provider community and market dynamics, including interrelationships among hospitals, physicians, and ancillary servicesExcellent written, verbal, and listening communication skills, along with strong business acumen, analytical, negotiation, organizational, strategic thinking, multitasking, and prioritization skillsDemonstrated success developing and negotiating complex financial rate structures and contract languageStrong project and priority management skills in fast-paced environmentsExperience negotiating rate structures and contract language aligned with the Company's business model while minimizing riskStrong understanding of contract structures with experience minimizing non-standard languageProven relationship-building skills with the ability to establish trust and credibility across all levels of the organizationCollaborative approach with experience working across teams and organizational boundariesStrong internal and external customer relationship management skillsUnderstanding of provider and competitor structures, relationships, and market dynamicsProfessional presence and effectiveness in in-person client interactionsStrong persuasion and influencing skillsEffective presentation and communication of the Company's value propositionWillingness and ability to travel, including overnight staysProfessional representation of the Company in all interactionsProficiency with computer software, hardware, and peripherals applicable to the roleBENEFITSWe realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.Your benefits will include:Medical, dental and vision coverage with low deductible & copayLife insuranceShort and long-term disabilityPaid Parental Leave401(k) + matchEmployee Stock Purchase PlanGenerous Paid Time Off - accrued based on years of serviceWA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service10 paid company holidaysTuition reimbursementFlexible Spending AccountEmployee Assistance ProgramSick time benefits - for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefitsEEO STATEMENTClaritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here.APPLICATION DEADLINEWe will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted.#LI-KB1