Director, Network Ops & Provider Engagement - Remote

TriWest Healthcare Alliance Corp.; Phoenix (AZ); Hybrid; USD 164,000 - 173,000; Full time

Benefits offered by this job

Medical, Dental and Vision Coverage

401(k) Retirement Savings Plan (with  

Paid time off

Tuition reimbursement

Job summary

TriWest Healthcare Alliance is seeking a Director to oversee Provider Network Operations across designated markets. You will manage relationships with large health systems, ensure network adequacy, and drive service delivery for VA and DHA programs.

Responsibilities include engaging providers, coordinating with MVS, Credentialing, Data, and Contracting teams, and guiding performance against SLOs. Relevant DoD background, healthcare analytics experience, and strong negotiation skills are

Qualifications

• Bachelor's degree in Business, Health Care Administration or equivalent experience.
• U.S. Citizen.
• Must be able to obtain a favorable Interim and adjudicated final Department of Defense (DoD) background investigation
• 7+ years of leadership and/or account management experience in managed care, a health plan, or a health system, including provider network or payer-provider relationship management
• Working knowledge of provider contracts with health systems, hospitals, or large provider groups, including reimbursement, discounts, and contract terms
• Demonstrated success resolving complex conflicts, driving results with internal and external partners and stakeholders, and proactively managing issues
• Experience and fluency in health plan credentialing, provider data systems, healthcare analytics, and/or performance management

Responsibilities

• Develops and maintains relationships with providers and customers within a designated market of states.
• Ensures that network adequacy objectives are attained in all geographic areas of responsibility.
• Lead partnership, advocacy, and service delivery for a portfolio of Health Systems across multiple states, along with large Provider Group strategic partnerships and National providers
• Support MVS Field Staff and Military Treatment Facility/VA Medical Center network/provider needs in their regions.
• Meets performance factors and contract requirements with assigned health systems and provider groups.
• Oversees development and training to network providers on changes and updates to TriWest processes and policies.

Skills

Leadership

Provider network

Negotiation

Healthcare analytics

Project coordination

Education

Bachelor's degree in Business/Health Care Administration

U.S. Citizen

Job description

TriWest Healthcare Alliance is seeking a Director to oversee Provider Network Operations across designated markets. You will manage relationships with large health systems, ensure network adequacy, and drive service delivery for VA and DHA programs.

Responsibilities include engaging providers, coordinating with MVS, Credentialing, Data, and Contracting teams, and guiding performance against SLOs. Relevant DoD background, healthcare analytics experience, and strong negotiation skills are