- Set the short and long term (12 month / 3 year) strategy for the recruitment organization to drive growth of the discounted provider network ensuring geographic coverage
- Direct target setting and revenue growth for the Provider Management Organization
- Lead the development of new network development concepts, technologies, and pricing models to meet emerging needs
- Understand, plan, and execute complex provider contracts
- Lead the Network Recruitment and Contracting team in the growth and development of the provider network including the delivery of service coverage that is geographically competitive to meet client needs
- Lead the Network Development team in evaluation and negotiation of contracts in compliance with company contract templates, reimbursement structure standards, and other key process controls
- Assure accurate implementation of contracts and collaboration with other departments to assure that contracts are successfully administered
- Ensure provider contracting policies are adhered to as related to standard contract language
- Coordinate timely responses to internal requests for information, reporting and audit functions.
- Prepare and deliver reporting with key metrics and continuously evaluate departmental performance against goals and recalibrate accordingly to meet expectation
- Responsible for creating a strong network development team and provide direct leadership, mentorship and coaching to develop and retain talent
- Develop, analyze, and monitor recruitment incentive plans
- Ensure department staff remains current in all aspects of workers compensation related rules, regulations, policies, and procedures and creates or modifies departmental policies to reflect changes
- Leverage data and analytics to make decisions and work closely with analytics organization to build metrics and tools to be able to see results proactively and business plan accordingly
- Responsible for P&L management: Fiscally responsible for operational expenses/costs; tracks expenses and assists in development of department budget
- Increases industry and financial acumen by participating in industry events, conferences, webinars, trainings, continuing education etc. (in person and virtually)
- Perform other job-related duties and projects as assigned
- Baccalaureate degree required. Advanced degree preferred.
- Ten plus years progressive experience in the healthcare industry with fee-for-service or value-based care contracting experience. Network Development experience in a healthcare preferred.
- External Interactions: Prior experience with researching, developing, recruiting, and contracting with key provider groups is preferred
- Prior experience working with Physical Therapy and related physical medicine providers is preferred
- Knowledge and experience with workers' compensation is highly preferred.
- Five plus years of Direct supervisory/Management Experience Required
- Skilled experience specifically with MS Excel, as well as experience with Microsoft Office suite required.
- Ability to travel on business required. (Minimum level.)
Director Development - Illinois, United States - Pegasus Knowledge Solutions, Inc.
Description
Title : Director Development - Healthcare Provider Network
Job Summary
The Director of Network Development's primary responsibility is to provide oversight and general management to the Network Development Department. The Director provides leadership direction to the network development team and continuously drives an efficient and effective business unit through strategic solutions leveraging data to make decisions related to network development and contracting. The Director utilizes critical thinking skills and results orientation to ensure the network delivers service coverage that is geographically competitive to meet client needs. This role requires a driven individual who is open to change, flexible, creative, and collaborative in a fast-paced environment. The Director functions in a strategic and proactive manner considering business needs and financial management.
Primary Duties & Responsibilities
Qualifications
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