Job Description

Posted Date: 9/12/2019

The Senior Director of Network Operations is directly responsible for developing, implementing, and leading a strategic approach to building and sustaining a robust provider network across all lines of business. Engage executive leadership in driving and prioritizing proactive initiatives that support key business objectives and drive business development opportunities.

  • Aggressively pursue opportunities to engage the provider community and stakeholders in the identification and development of quality initiatives, and innovative reimbursement models
  • Identify and advance partnership opportunities, keeping executive leadership informed of community activities and competitive approaches
  • Draft, disseminate, summarize, and analyze physician/provider data including profiles, physician scorecards, member profiles, clinical alerts systems and other key evidence-based decision support tools
  • Work in collaboration with department directors to identify potential challenges and opportunities, and work to develop consensus approaches toward improving the overall delivery system
  • Work with internal subject matter leads and executive leadership including compliance and marketing divisions to ensure consistency and coordinated engagement with the provider community
  • Direct Supervision of all department staff while providing leadership and growth of staff through planned development and coaching
  • Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. Provide guidance in evaluating opportunities to expand or change the network to meet Company goals
  • Routine, proactive and meaningful interaction with finance, medical management, operations and sales to ensure a competitive network is in place, and optimal terms and/or provisions are negotiated into contract development/updates, and implemented as intended
  • Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts
  • Valid Arizona Driver’s license required as travel is required
  • Approximately 40% travel within the state of Arizona

Education:

  • Bachelor’s Degree in business administration, public health, public administration, health care administration, management, finance, or related field. Master’s Degree preferred

Years of Experience:

  • 5+ years of experience in managed care network development and provider relations/contracting management in a health care and/or managed care environment
  • Previous management experience including responsibilities for hiring, training, assigning work, and managing performance of staff

Application Instructions

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