Network Development Associate at Bright Health
- 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.
- 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