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Director of Network Initiatives in Cypress, CA at Beacon Health Options

Date Posted: 4/4/2019

Job Snapshot

Job Description

ABOUT THE POSITION

Under the leadership of the regional VP of Network Strategy, provide direction and oversight for implementing strategic initiatives and process improvement. Serve as the second to the regional VP of Network Strategy to ensure key functions and initiatives are tracked, reported and aligned with regional market priorities. Lead communication efforts with shared services and regional market leadership. Work collaboratively with other Directors/AVPs of Regional Provider Initiatives to standardize network operations across regions. Key project manager and leader to ensure seamless implementation of value-based purchasing, audits, and other cross-disciplinary functions within the region.

Position Responsibilities:

  • Develops, submits and implements departmental and overall Beacon Arkansas goals and objectives which align with company and corporate goals and objectives/strategic priorities.  This will include coordination of medical cost savings initiatives with Clinical and Network leadership.
  • Maintain an effective working relationship that meets the needs of the client, partnership members, corporate Finance department and overall corporate leadership.  Key external relationships will include State personnel connected with program, enrollment and rate-setting processes as well as Empower PASSE Board.
  • Provides financial expertise on developmental planning and implementation for the company’s product and services to include both behavioral and physical health.
  • Assist engagement center and corporate leadership in providing financial and operationa Partner with the VP Network Strategy to develop and implement advanced market level provider strategies.  Drive implementation through coordination with regional and corporate staff.
  • Provide leadership for projects designed to enhance operational functions surrounding providers, to include oversight of audits, implementation of new programs, performance reporting, and process improvement.
  • Support functional areas under the regional VP of Network Strategy to include Provider Relations, Contracting, and Network Development.
  • Support efforts to proactively identify and engage target providers who are candidates for innovative partnership models that address regional needs, such as pay-for-performance, bundled payments, payments to support accountable care organizations, hospital value-based purchasing, and various other alternative payment models.
  • Drive collaborative design of innovative partnerships with providers that will deliver value to the behavioral health system through improved outcomes, decreased costs, or other metrics.
  • Articulate and communicate a strong value proposition for proposed partnership models in order to secure necessary approvals and investments both internally and from all deal participants.
  • Leverage strong knowledge of regional State and Federal regulations, laws and legislative agendas regarding healthcare industry that impact Beacon and our provider network in order to improve partnership models.
  • Deliver improved client and provider satisfaction through the execution of strategic programs.
  • Accountable for developing, tracking and reporting on regional network team deliverables and performance.
  • Ensure regional VP of Network Strategy is aware of status and risks of network priorities and lead development of corrective actions.  
  • Develop collaborative relationship with internal customers to understand market dynamics, define priorities and create best practices. 
  • Ensure team goals and priorities are aligned with the regional market strategy.
  • Lead regional and corporate initiatives aimed at improving operations and the provider experience.
  • Represent the regional Network team in any regional or national PR or Contracting initiatives.   Responsible for understanding provider impact and ensuring both plan and external requirements are met.
  • l oversight of physical health TPA.
  • Provide all required financial reporting to corporate leadership, partnership and state client. Coordinate with corporate Finance all department of insurance reserve requirements and reporting.
  • Coordinate monthly activities with corporate actuary to ensure medical expense estimates and IBNR reporting are as accurate as possible.
  • Work with Network department and CEO to develop and implement alternative payment models with key providers.

Position Requirements:

Education: Bachelor’s degree required, graduate degree preferred (specifically MBA, MPH, or MSW)

Relevant Work Experience:

  • Seven to ten (7-10) years of progressive management experience with at least two of those years in a client-facing role
  • Three-five years healthcare payor (including managed care) experience preferred
  • Three-five years provider negotiations experience
  • 2+ years of enterprise-wide program experience
  • 2+ years of project management leadership experience

To Apply:

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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled

At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.