ABOUT THE ROLE
Bright Health Care contracts and manages all of Bright Health’s Care Partners, providers, and other network participants. The team is responsible for the assessment, assembly, management, optimization, commercialization, and performance of its “Smart Networks” across all of Bright Health’s markets. These high performing clinical networks, centered around our Care Partner relationships and local market primary care providers, aim to deliver integrated, affordable and personalized health care, tailored to the unique needs of each community and individual.
The Director, Provider Contracting & Value-Based Care is accountable for contract negotiations with large medical groups and IPAs. This position will play an integral role in driving the company’s performance by building, optimizing, and transforming our insurance networks. This position will be responsible for contracting with medical groups and IPAs including both value-based and fee-for-service contracts. This role will also provide contract and relationship management for the completed value-based contracts to maintain a strong relationship with the provider after contract execution.
This position is based in New York, Minneapolis or remotely.
- Negotiate fee-for-service and value-based contracts with large medical groups and IPAs that provide Bright Health with a high performing network
- Lead the development of the contract strategy for each negotiation collaborating with network, market and actuarial leadership and work closely with our actuarial team to develop the financial terms of the contract
- For providers on a value-based contract, manage ongoing relationship and performance, including identifying opportunities for performance improvement, review of reporting and resolution of issues with Bright Health’s internal network team
- Assist network team to advance short-term and long-term best practices for fee-for-service and value-based contracting, including governing terms, reimbursement rates and structures, reporting, and contract template structure
- Partner with network’s value-based contracting program network team to drive improvement across value-based contracting
- Collaborate with internal partners to advance our relationship with your provider partners – finance reporting
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- A Bachelor’s Degree in business, economics, healthcare administration, or a related field is required
- At least eight (8) years of professional experience with five (5) years of healthcare experience is required
- Experience with successfully executing and implementing payer-provider contracts is required
- Strong contract negotiation skills
- Excellent multitasking and prioritization skills with a proven ability to manage multiple contract negotiations and provider accounts in parallel
- Ability to effectively engage providers
- Bias toward action; sense of urgency, self-initiative, and ownership of work
- Strong written and verbal communication skills with an ability to effectively collaborate with internal and external partners
At Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.
We’re Making Healthcare Right. Together.
We've won some fun awards like: Great Places to Work, Modern Healthcare, Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.