VP, Ancillary Provider Strategy & Network Management

Highmark Health; Pittsburgh (Allegheny County); On-site; USD 95,000 - 150,000; Full time

Job summary

Highmark Health in Pittsburgh seeks a senior leader to manage provider networks across markets, focusing on ancillary networks and reimbursement model innovation to control costs and improve member experiences.

The role guides contracting strategies with Product, Clinical, and Reimbursement teams, overseeing signatory authority and collaboration with internal stakeholders to drive value-based care initiatives.

Qualifications

• Bachelor’s degree and 7 years of experience in healthcare/ managed care in a management role.
• 7 years of experience in provider contracting, benefit design, medical management, or healthcare administration.
• Excellent written and verbal communication skills.
• Leadership, teamwork, strategic thinking, influencing, negotiating skills, and operations execution.

Responsibilities

• Oversee contract negotiations and network management programs for ancillary providers and national/multi-market providers.
• Own and manage contract signatory authority for such provider contracts.
• Establish benchmarks and monitor parameters to ensure product and service competitiveness.
• Develop and implement pay-for-value contracts across markets.
• Collaborate on a network management strategy for post-acute care services, including SNF and Home Health.
• Represent Highmark Health to internal stakeholders and external providers and regulators.

Skills

Bachelor's degree

Leadership

Negotiation

Communication

Strategic thinking

Influencing

Operations

Healthcare experience

Education

Bachelor's degree in healthcare/related field

Job description

Highmark Health in Pittsburgh seeks a senior leader to manage provider networks across markets, focusing on ancillary networks and reimbursement model innovation to control costs and improve member experiences.

The role guides contracting strategies with Product, Clinical, and Reimbursement teams, overseeing signatory authority and collaboration with internal stakeholders to drive value-based care initiatives.