Sr Manager, Provider Network Development

Responsible for leading network growth by attracting and retaining doctors and strategic partners to the network. Support ongoing and future network provider integrations and initiatives. Provide operational support, defining and delivering comprehensive new system enhancements, processes, and training to meet state, federal, and client requirements.

Direct the Provider Network teams responsible for recruitment and retention of providers across all VSP networks and the implementation and operational management of provider data to ensure accurate claim submission, doctor payments, tiered provider benefits, and provider directory

Communicate strategic goals and the impact the teams’ efforts have in achieving the division and organizational goals

Lead and manage network operational activities across all modalities including independent private practice, retail and strategic providers, telehealth, mobile, and all network exceptions

Participate in the development of key division initiatives; lead and manage the implementation of assigned corporate strategies and follow up on operational performance, training and metrics for Provider Network to ensure operational stability

Accountable for data integrity oversight within the Network Development team

Manage the network in accordance to provider contractual obligations

Direct the team to achieve and maintain service goals including implementing process and system changes to create operational efficiencies. Responsible for the Provider Network phone line and email boxes

Work closely with SBUs, payment and product integration, and regulatory compliance and participate on client calls as a Network Subject Matter Expert

Partner with Legal on developing and reviewing vendor contracts, unique practice ownership scenarios and provider escalations

Responsible for the deployment and delivery of insurance and regulatory training content for providers and their staff to ensure state and federal requirements are met

Responsible for provider networks, including maintaining appropriate access and developing and maintaining compliance with network standards across all networks as well as client specific network performance guarantees

Oversee business area impact assessments, business analysis and implementation of corporate and divisional projects, ensuring operational readiness

Partner with division leadership and business partners, to recommend solutions or enhancements to the provider network

Job Specifications

Typically has the following skills or abilities:

Bachelor’s degree in related field or equivalent experience

Minimum of 3 years of management experience with responsibilities for hiring, training, assigning work and managing performance of direct reports

Minimum of 8 years’ experience in the health care industry or equivalent preferred

Demonstrated ability to resolve complex issues

Demonstrated ability to learn, interpret and apply information in contractual documents, policies, and procedures

Excellent leadership skills, …