- Develops and implements a network to meet the needs of the SBU, clients and members.
- Employs excellent development and innovation skills in the areas of new protocols, policies and procedures for the network's formation and successful development.
- Accountable for deploying the organization's provider relationship and contract strategy and deploying Magellan's provider capabilities across relevant functions (product, value-based reimbursement (VBR), analytics, clinical transformation, etc.) into the market through provider relationships that drive value to the communities served.
- Develops and implements provider and delivery system strategies aligned with business needs and growth initiatives.
- Supports strategy for new products/product enhancement and aligns with delivery system approach.
- Ensures the alignment of network and clinical strategies in coordination with other business leadership.
- Oversees provider network analytics from a growth, coverage and cost perspective.
- Ensures unit cost targets are met.
- Works cross-functionally to connect the network with all necessary departments across the business.
- Assures long-term, mutually successful provider relationships.
- Guides development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management.
- Directs all provider (free-standing facility, hospital, and in-office) recruitment activities.
- Develops negotiation strategies to ensure results are within financial projections.
- Manages financial goals (e.g., control care cost trends, profitability) as defined by the business operations and the SBU, including assuring that the network is cost effective, marketable, stable and offers appropriate access.
- Monitors ongoing provider performance changes in cost and utilization needs.
- Develops and maintains positive relationships between Magellan and providers, and influences and changes behavior of providers in accordance with business operations goals and objectives.
- Prepares, analyzes, reviews and projects financial/systems impacts of various negotiation strategies.
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SVP, National Network Development and Delivery Strategy - United States - Magellan Health
Description
Develops and manages a national network of behavioral health providers and implements a delivery system strategy that meets business and customer requirements. Guides the development and support of provider networks as well as unit cost management activities through financial and network pricing modeling, analysis, and reporting. The SVP is responsible for overseeing network development and creating value-based initiatives. This includes leadership oversight of our provider network clinical initiatives, provider engagement and relations, contracting and credentialing and provider data management. This leader is responsible for ensuring all provider networks meet the regulatory requirements for contracts and performance and ensuring all health plan delegated network functions are met. A critical aspect of this role is ensuring positive and proactive relationships are established and maintained with key health plan and provider/institutional network owners and leaders. Evaluates and negotiates contracts to ensure compliance with company contract templates, reimbursement structure standards, and other key process controls. Responsible for strategic oversight of behavioral health network of services that supports member access and meet cost of care goals and budget. Delivers insight and supports strategy into product development and operational improvements. Provides thought leadership to all aspects of the network management in support of the SBU. Implements network innovations where necessary and assures ongoing compliance with important payer, industry, and regulatory requirements.Other Job Requirements
Responsibilities
General Job Information
Title
SVP, National Network Development and Delivery StrategyGrade
38Work Experience - Required
Work Experience - Preferred
Education - Required
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Salary Range
Salary Minimum:
$255,740Salary Maximum:
$485,900This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
