Sr Network Innovation/Strategy Consultant
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Job Summary
This position is responsible for value-based care and new network strategy and development activities at an advanced consultative level to enhance market stance, competitive capabilities and profitability. Responsible for the identification, evaluation and development of innovative network / care management solutions; direction and expansion of value based care provider contracting (patient center medical home, aco, bundled payment models, specialty payment models, etc.); identification and evaluation of competitive provider pricing models, high economic value and performance based reimbursement programs; assessment of new network opportunities and value propositions; and development, promotion and presentation of network advantages/strengths.
JOB REQUIREMENTS:
Bachelor’s degree and 6 years managed care or network management experience at the Health Plan level or 10 years managed care or network management experience at the Health Plan level.
Experience in provider contracting and negotiations.
Experience in financial analysis related to provider reimbursement, payment methodologies and provider performance measures.
Innovation and strategy skills
Consultative skills
Analytical skills and experience developing analytical presentation and pricing models.
Clear, concise and effective verbal and written communication skills including interpersonal and presentation skills.
Strategic thinking, critical thinking and problem-solving skills.
Business acumen and ability to build credibility with all levels of the organization.
Financial acumen
Independence, resourcefulness, and ability to meet deadlines.
Knowledge of healthcare benefits, terminology, and concepts.
Experience developing and presenting to executives or provider groups; strong delivery skills.
Knowledge of network management trends and innovations.
Ability to collaborate effectively with stakeholders and key internal partners.
PREFERRED JOB REQUIREMENTS:
Master’s degree
Experience in developing and writing value based provider contracts
Experience in use of membership data, premium data and/or claims data.
Knowledge of State and Federal laws and regulations.
Experience with network management pricing modeling.
Experience in innovation
We encourage people of all backgrounds and experiences to apply.
Even if you don’t meet every listed qualification, apply anyway - you might have qualifications we haven’t even thought of yet.
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HCSC Employment Statement:
We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range
$88,700.00 - $160,200.00