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Director, Networking Strategy

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Location
Lawrenceville, NJ
Job Type
Direct Hire
Date
Oct 11, 2016
Job ID
2001986
Responsible for the design, development and maintenance of hospital, physicians and ancillary services networks that reinforce our client's business goals and compliance.  This position is responsible for fostering relationships with hospitals, physicians and ancillary services to maintain serving levels and provider satisfaction. The incumbent is responsible for the administration of the Professional Contracting and Servicing department including maintaining adequate staffing, structure and policies.   This position is responsible for maintaining a cost effective quality network and managing unit cost.  This position will report directly to the President and COO.

Major Responsibilities:

  1. Responsible for strategy, oversight and contracting of hospital physician and ancillary services.Works with management team to develop and implement networking strategies that advances the vision of the company and supports corporate goals related to quality, costs and market share.
    1. Responsible for maintenance of state standards and compliance with contract and regulatory standards.
    2. Works as a creative resource on the network model alternatives, reimbursement strategies and options, and alternatives for differentiating the client in the contracting marketplace.
  2. Assures that the appropriate process, structure and staff are in place to support proactive provider partnerships throughout all phases of contract development, maintenance, service and review.
  3. Develops and implements strategies to improve provider satisfaction and build working relationships.
  4. Responsible for managing unit costs,
  5. Responsible for fee schedule, pricing management, impact analysis and contract results.
  6. Evaluates the effects of network strategies on internal operations and secures  buy-in on the part of the leadership team to changes that may be needed.
  7. Develops and maintains appropriate external relationships in support of the network.  Monitors and evaluates the external business environment including competitor activity to inform strategic direction.
    1. These relationships include providers, regulatory agencies and professional associations.
    2. Develops solid working relationships with the hospital community to cultivate mutually beneficial arrangements.
  8. Develops and supports appropriate medical and administrative cost initiatives.
  9. Plans and maintains annual budgets. Seeks opportunities to maximize impact of spending.
  10. Directs staff to ensure overall client satisfaction and appropriate level of service delivery.
  11. Develops and monitors goals for staff and provides ongoing feedback and coaching.
  12. Conducts performance reviews on an annual basis and administers salaries for the staff.
  13. Directs the employment activities of the office that include staffing, development, and training.
  14. Ensures staff meets all regulatory requirements and comprehends and complies with best practices, professional standards, internal policies, and procedures.

Skills and Abilities:

  1. Requires excellent written and oral communication skills
  2. Requires leadership and decision making skills
  3. Requires demonstrated aptitude for analytical thinking and ability to report findings accurately.
  4. Requires strong consulting, sales and negotiation skills.
  5. Requires strong interpersonal, organizational and problem solving skills
  6. Ability to network and create associations with all level of government and business leaders.
  7.  Ability to develop strategic plans  to support company goals.

Education/Experience:

  1. Requires a Bachelor's degree in business, marketing, finance, accounting, health administration or other related field from and  accredited college or university.
  2. Prefers a Master's of business Administration.
  3. Requires at least ten (10) years experience with progressive responsibility in health care management.
  4. Requires five (5) years business experience in managed care network development/management.
  5. Requires supervisory staff management and administrative experience
  6. Prefer experience working in a highly regulated government environment.

Knowledge:

  1. Requires comprehensive knowledge of contracting and a solid understanding of managed care, including capitation and other forms of risk sharing.
  2. Requires knowledge of health care delivery systems, distribution channels, health care industry and health insurance industry.
  3. Requires knowledge of strategic planning and development.
  4. Prefers knowledge of the hospital and physician communities in the area of Responsibility.
  5. Knowledge of managed care operations, pricing and reimbursement and network contracting and servicing functions.
  6. Knowledge of PC’s and applicable software application.
  7. Knowledge of applicable laws and regulations as well as of Governmental Agencies and Regulatory Bodies

Travel:

Required to cover the State of NJ to maintain hospital, provider and ancillary network relationships.  Travel required is a minimum of 20%.