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Director, Network Development


This is a Contract position in Jupiter, FL posted December 18, 2021.

*Job Summary*The Director of Network Development will provide an essential management role to support retention and expansion of ilumed’s provider network. Serve as a key team member in establishing quality-based, cost-efficient provider networks and form viable provider partner relationships for the benefit of ilumed customers. Establish provider networks and apply performance-based reimbursement structures as appropriate to enhance quality and efficient care models. Work cooperatively with colleagues to fulfill ilumed’s vision of excellence in health management.*Essential Job Functions*· Develop strategic partnerships to support company vision and goals· Implement policies, procedures and quality standards for network management· Ensure provider network footprint supports clinical leadership requirements for a top performing provider network that yields cost efficient quality outcomes· Establish meaningful provider network growth that aligns with needs of beneficiaries· Evaluate provider network performance for improvement opportunities· Implement budgeting and forecasting procedures to comply with targets set for network management activities· Work with senior leadership team to analyze claim trend data and to incorporate results into strategy decisions for contract negotiations· Assist in the development of quarterly reports for the senior management team to report on provider network footprint, membership growth by state/county and forecast of market expansions· Assist in governmental relationships and compliance with CMS guidelines· Assist VP of Network Development in managing CMMI annual deadlines for provider network submissions*Attributes for success: *· Make timely proficient decisions and complete assigned tasks independently· Strong negotiation skills, strong closer· Attention to detail, highly organized in creating workflows and executing deliverables· Ability to analyze financial reports and identify trends/variances “Big Picture” thinking· Highly effective oral/written communication skills· Adapts quickly to changes needed to expand vision and facilitate vision execution*Skills and experience: *· Ability to work in a fast paced environment· 4+ years negotiating provider contracts including physician, ancillary and hospital with multiple payment methodologies· 2+ years’ experience with global risk/full delegation contracts· Provider relations experience· Bachelor’s degree or equivalent experience in Business Administration, Healthcare Administration or related field. MBA or MHA degree preferred· 2+years of experience in population health/global risk network development and provider relations/contract management in a health care and/or managed care environment.· Contract drafting experience· People management experience· Microsoft Office Suite software applications· Analytical and problem-solving· Organizational and time management· Project management and Multi-tasking*Physical Demands*· Ability to travel· Sitting, standing, bending, reaching and the ability to mobilize throughout the office.· Pro-longed work at computer monitors.· Lift and/or move up to 10 lbs.*Additional Information*· Must abide by all HIPAA, Confidentiality & Privacy Laws· Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.*DISCLAIMER: **_Job descriptions are not meant to be all-inclusive and/or the job itself is subject to change. Nothing in this job description restricts ilumed’s right to assign or reassign duties and responsibilities to this job at any time._*Job Type: Full-timeBenefits:* 401(k)* 401(k) matching* Dental insurance* Health insurance* Health savings account* Life insurance* Paid time off* Vision insuranceSchedule:* Monday to FridayAbility to commute/relocate:* Jupiter, FL 33458: Reliably commute or planning to relocate before starting work (Preferred)Education:* High school or equivalent (Preferred)Experience:* contract negotiation: 4 years (Preferred)Willingness to travel:* 25% (Preferred)Work Location: One location

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