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Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.

If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.


 

SCOPE OF ROLE

The Bright Health network management team contracts and manages Bright Health’s Care Partners, providers, and other network participants. The team is responsible for the assessment, assembly, management, optimization, commercialization, and performance of Bright Health’s narrow network across Bright Health’s markets. These high performing clinical networks, centered around our Care Partner relationships including IPAs and medical groups with strong population health management capabilities, aim to deliver integrated, affordable and personalized health care, tailored to the unique needs of each community and individual.

The Director, Provider Contracting is accountable for contract negotiations with large IPAs and medical groups primarily in California. This position will play an integral role in driving the company’s performance by building, optimizing, and transforming our provider networks. This position will be responsible for contracting with IPAs and medical groups including professional capitation, value-based care and fee-for-service contracts.

ROLE RESPONSIBILITIES

The Director, Provider Contracting job description is intended to point out major responsibilities within the role, but it is not limited to these items.

  • Negotiate professional capitation, fee-for-service and value-based care contracts with IPAs and large medical groups that provide Bright Health with a high performing network
  • Lead the development of the contract strategy for each negotiation collaborating with network, market and actuarial leadership and work closely with our actuarial team to develop the financial terms of the contract
  • Assist network team to advance short-term and long-term best practices for professional capitation, fee-for-service and value-based care contracting, including governing terms, reimbursement rates and structures, reporting, and contract template structure
  • Partner with network’s value-based care contracting program network team and internal partners to drive improvement
  • Collaborate with internal partners to advance our relationship with your provider partners – finance reporting

SUPERVISORY RESPONSIBILITIES

  • This position does not have supervisor responsibilities.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • A Bachelor’s Degree in business, economics, healthcare administration, or a related field is required
  • At least eight (8) years of professional experience with five (5) years of healthcare experience is required
  • Experience with successfully executing and implementing payer-provider contracts in California is required

PROFESSIONAL COMPETENCIES

  • Strong contract negotiation skills
  • Excellent multitasking and prioritization skills with a proven ability to manage multiple contract negotiations and provider accounts in parallel
  • Ability to effectively engage providers
  • Bias toward action; sense of urgency, self-initiative, and ownership of work
  • Strong written and verbal communication skills with an ability to effectively collaborate with internal and external partners

WORK ENVIRONMENT

  • The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel may be required.

 

 

We’re Making Healthcare Right. Together.

We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:
 
Focusing on Consumers
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
 
Building on Alignment
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.
 
Powered by Technology
We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.
 
          

 
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
 

 

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