Director, Provider Network Strategy & Negotiations

Medical Mutual; Brooklyn (OH); On-site; USD 140,000 - 190,000; Full time

Benefits offered by this job

Laptop provided

On-site fitness centers

Gym membership reimbursement

On-site cafeteria

Discounts for employees

Cash rewards program

Business casual attire

Job summary

Medical Mutual in Brooklyn, OH is seeking a Director of Provider Network Management to oversee relationships with physician, professional, institutional and ancillary providers, negotiating contracts and reimbursement strategies to optimize cost, access and quality across products.

You will lead a team, partner with Sales, Clinical and Network Informatics, ensure regulatory compliance, and drive initiatives that improve provider access, satisfaction and collaboration across products.

Qualifications

• Bachelor's degree in Business Administration, Healthcare Administration, Finance, or related field.
• In lieu of Degree, may consider equivalent combination of education and experience.
• MBA or Health Care Administration (MHA) preferred.
• 8 years progressive experience in provider network development, managed care, or equivalent, 5 years in managerial role.
• Experience in establishing provider networks for commercial and government programs.

Responsibilities

• Reviews proposed contracts and manages multiple negotiation processes to achieve network targets.
• Establishes and maintains relationships with high volume providers and health systems.
• Directs operations and staff including provider access, quality, and education.
• Partners with Sales, Clinical, Network Informatics to achieve customer satisfaction goals.
• Collaborates with internal resources and external providers for projects and government programs.
• Ensures regulatory compliance and accreditation standards.

Skills

Provider network development

Contract negotiation

Regulatory understanding

Analytical skills

Stakeholder communication

Leadership

Education

Bachelor's degree in related field

MBA or MHA preferred

Tools

Microsoft Office

Job description

Medical Mutual in Brooklyn, OH is seeking a Director of Provider Network Management to oversee relationships with physician, professional, institutional and ancillary providers, negotiating contracts and reimbursement strategies to optimize cost, access and quality across products.

You will lead a team, partner with Sales, Clinical and Network Informatics, ensure regulatory compliance, and drive initiatives that improve provider access, satisfaction and collaboration across products.