Director, Network Development - R12757

Job SummaryDirector, Network Development is responsible for hospital, provider and ancillary provider contracting, service, and provider data integrity to facilitate optimal member access, successful business growth initiatives and sound plan financial performance as it relates to unit pricing in select states, regions or markets.Essential FunctionsResponsible for the development of networks in new marketsWill have significant interactions with third parties, contractors, and various companies engaged to develop networks in new marketsResponsible for provider recruitment of states, geographic regions or markets as defined in the corporate strategic plansDevelop a Contracting Strategy on an as needed basis for the various targeted marketsDevelop the key metrics to ensure a high level of network adequacyResponsible for robust competitor and provider competitive analysis and the creation of other information to formulate a business decision related to the provider networkCompile quarterly and annual statisticsResponsible for the effective integration of new providers into the Network Operations infrastructureEnsure that the provider setup for new markets or regions is consistent with the Departmental standardsProvide oversight of provider contracting activities when completed by contractors or other individuals or entities working on behalf of the Health PlanResponsible for aggressive recruitment programs including recruitment materials and development and facilitation of quarterly reportsProvide formal feedback, documentation and resolution of areas for improvement and monitor sustained improvementReview audits of all performance from a productivity, performance and quality perspective; address issues as identifiedImplement a process in conjunction with other departmental Directors to ensure an effective approach to on-boarding new providersEnsure the network complies with all regulatory requirements as well as with all company-mandated policies and proceduresEnsure provider network is adequate, cost effective, competitive, stable and meets the corporate and regulatory access requirementsInteract with the Finance Department in terms of pricing for provider contractsChair or co-Chair operational committees that relate to the contracting processParticipate in training sessions for providers and staff as appropriate.Implement performance improvement initiatives to improve Provider Satisfaction Scores incrementally on an annual basisPerform any other job duties as requestedEducation And ExperienceBachelor’s degree or equivalent in health-related fieldMaster’s Degree or equivalent preferredMinimum 5 years management experience requiredMinimum of 3 years contract negotiation experience requiredManaged care experience highly preferredCompetencies, Knowledge And SkillsIntermediate computer skillsProficient in Microsoft Word, Outlook and ExcelKnowledge of Network Management Processes & ServicesAbility to manage and prioritize multiple tasks, promote teamwork and fact-based decision makingCommunication skillsAbility to work independently and within a team environmentAttention to detailFamiliarity of the healthcare fieldCritical listening and thinking skillsTraining/teaching skillsStrategic management skillsProper grammar usageTime management skillsProper phone etiquetteDecision making/problem solving skillsLeadership experience and skillsResiliency in a changing environmentLicensure And CertificationEmployment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in this position, employment in this position will be terminatedTo help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued 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.CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.Working ConditionsMobile Worker: Will work at different office locations established by CareSource; will be required to travel approximately 35% of time to perform work duties; may be required to stand and/or sit for long periods of timesA valid driver’s license, car and insurance are necessary for work related travelRequired to travel to provider offices and will be exposed to weather conditions depending on geographic locationCompensation Range$101,700.00 - $177,930.00 CareSource 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 latitude required for the role, and other external and internal data when establishing a salary level. In addition to base 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 TypeSalaryCompetencies Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the BusinessThis job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.