Manager, Network Development at Bright Health
- Owns the development of provider contracting efforts from start-to-finish, including but not limited to process oversight, strategic diligence, outreach, and contract negotiations with regards to mid-sized and large hospitals and health systems, large and small physician groups and ancillary providers to execution.
- Lead Bright Health network development efforts across several markets, partnering closely with market teams, sales, Health Optimization, and other Integrated Delivery Development functions.
- Leads and manages the collaboration with our Care Partners to analyze, design, and develop networks through ongoing evaluation of both current and potential network participants.
- Supports enhancement of Bright’s portfolio of strategic multi-regional network partnerships to compliment local network development efforts.
- Manage ongoing network participant participation and performance, including performance analytics and management as well as contract renewals and terminations.
- Partner with stakeholders across the organization including but not limited to sales, finance, regulatory, medical management to drive strategic priorities and initiatives.
- Monitor utilization/trends for non-participating providers and execute on organizational strategies to ensure members are seeking care with participating providers when appropriate.
- Accountable for leading negotiations with Care Partners and other sophisticated entities.
- Assess, manage, and develop network development team members to support achievement of network development goals.
- Other duties and responsibilities as assigned.
- This position has supervisory responsibilities for some Network Strategy/Development employees.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- A Bachelor’s Degree in business, economics, healthcare administration, or a related field is required; extensive relevant experience will be considered in lieu of a degree.
- Seven (7) years of experience, with at least five (4) years of experience in network development, network management, or reimbursement model design required.
- Three (3) years prior management experience strongly preferred.
- Experience with successfully executing and implementing payer-provider contracts or partnerships required.
- Experience with developing, presenting and analyzing various types of financial analyses in order to make informed strategic decisions required.
- Desire and ability to move quickly between strategic leadership, tactical execution, and managing analytics
- Knowledge of managed care practices and procedures, specifically in contracting language and negotiations. Provider relations is preferred
- Ability to effectively engage providers, ranging from national providers to regional integrated delivery systems to local physician practices
- Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures
- Excellent multitasking and prioritization skills with a proven ability to manage multiple projects in parallel to completion
- Superb written and verbal communication skills with an ability to effectively collaborate with internal and external executive leadership