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Curative · 17 hours ago

Director Network Development

Austin, TX

Full-time

Hybrid

Mid, Senior Level

7+ years exp

Curative is building the future of health insurance with innovative employer-based plans. The Director Network Development oversees the development and management of insurance networks to improve affordability and quality outcomes while managing provider relationships and negotiation strategies.

Health CareHealth DiagnosticsHealth InsuranceMedicalMedical DevicePersonal Health

Responsibilities

Manages contract negotiations with Major Health System and large physician groups and ancillary providers; conducting several negotiations simultaneously to meet growth demands

Deep understanding and experience with all clinical specialties to ensure contract terms and conditions address the coding structures which are most impacted by negotiations

Proactively builds relationships that nurture provider partnerships to support the local market strategy

Initiates, nurtures, and maintains effective channels of communication with matrix partners including but not limited to, Claims, Medical Management, Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing

Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain competitive position

Identify and manages initiatives that improve total medical cost and quality; including renegotiation of existing agreements

Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms

Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review analysis of reports as part of negotiation and reimbursement modeling activities

Assists in resolving elevated provider service complaints; researching and negotiating with internal/external partners/customers to resolve complex and/or escalated issues

Manages key provider relationships and is accountable for critical interface with providers and business staff

Coach and support newer team members on strategies and approaches to successful negotiations

Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape

Partner with Regulatory Affairs to ensure all network filings are timely and accurate; including participation with Compliance to ensure adherence to established guidelines supporting Mental Health Parity

This position assumes and performs other duties as assigned

Qualification

Contract negotiationProvider relationship managementFinancial acumenHealth systemsCommunication skillsCustomer centricProblem solvingTeam player

Required

Superior problem solving, decision-making, negotiating skills, contract language and financial acumen

Experience with complex Hospital / Health Systems, Large Physician Groups and Ancillary provider contracting and negotiations

Experience negotiating delegated credentialing agreements

Experience in developing and managing key provider relationships including senior executives

Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners

Intimate understanding and experience with larger, more complex integrated delivery systems managed care, and provider business models

Team player with proven ability to develop strong working relationships within a fast-paced organization

The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations

Customer centric and interpersonal skills are required

Bachelor's degree (B. A.) from four-year college or university

7+ years of work experience beyond degree within provider contracting and/or health insurance

Must have current hospital and/or large group and ancillary contracting experience in appropriate state

Existing relationships with major health systems and large physician groups in appropriate state is required