ABOUT THIS ROLE

The Integrated Delivery Development team is responsible for partnering with our Care Partners to turn their provider networks into market leading integrated delivery systems. We are reimagining how the network development, network management, and provider relations functions can advance affordable, simple, and personal care for our members. The Provider Contract Associate, Network Development – Active Markets and National Partnerships will be a key contributor to our team and will act as a thought leader for the entire organization. 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 supporting Bright’s relationship development with key national and local network participants of Bright’s insurance networks as well as for advancing reimbursement best practices alongside our Care Partners.

ROLE RESPONSIBILITIES

• Support the development of provider contracting efforts from start-to-finish, including but not limited to process oversight, strategic diligence, outreach, and contract negotiation and execution.
• Effectively negotiate rates, structures, and contract language with a range of provider types across multiple geographies
• Support collaboration with our Care Partners to analyze, design, and develop networks through ongoing evaluation of both current and potential network participants
• Support and enhance Bright’s portfolio of strategic national and 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.
• Other Duties and responsibilities as assigned.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• A Bachelor’s Degree in business, economics, healthcare administration, or a related field is preferred. Experience in contracting, provider relations, provider servicing, or any combination of education and experience which would provide an equivalent.
• One (1) or more years experience in network development, network management, with a focus on hospitals, IPAs, large and small pyhsican groups and ancillary service providers or reimbursement model design required.
• Experience in negotiating simple to complex managed care/commercial contract language required.
• In depth knowledge of Medicare terminology required.
• 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 preferred.

PROFESSIONAL COMPETENCIES

• 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

WORK ENVIRONMENT

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel may be required. 

ABOUT US

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.

BRIGHT ON!