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 Network Development team is responsible for partnering with our Care Partners including all other Network relationships to turn their provider networks into market leading and high performing integrated delivery systems. We are reimagining how the network development, network management, and provider relations functions can advance affordable, simple, and personal care for our members. The State Manager, Network Development will be a leader on our team and will act as a thought leader for the entire organization. This position will play an integral role in driving the company’s performance by building, optimizing, and transforming our insurance networks. This position will be responsible for supporting Bright’s relationship development with key national and local network participants across their designated market of Bright’s insurance networks as well as for advancing reimbursement best practices alongside our Care Partners.
The State Manager, Network Development job description is intended to point out major responsibilities within the role, but it is not limited to these items.
- Owns the development of provider contracting efforts from start-to-finish, including but not limited to process oversight, strategic diligence, outreach, and contract negotiations with regards to mid-sized and large hospitals and health systems, large and small physician groups and ancillary providers to execution.
- Lead Bright Health network development efforts across several markets, partnering closely with market teams, sales, Health Optimization, and other Integrated Delivery Development functions.
- Leads and manages the collaboration with our Care Partners to analyze, design, and develop networks through ongoing evaluation of both current and potential network participants.
- Supports enhancement of Bright’s portfolio of strategic multi-regional network partnerships to compliment local network development efforts.
- Manage ongoing network participant participation and performance, including performance analytics and management as well as contract renewals and terminations. Participates in Market stakeholder meetings and prepares written recommendations on network strategies as requested
- Partner with stakeholders across the organization including but not limited to sales, finance, regulatory, medical management to drive strategic priorities and initiatives.
- Monitor utilization/trends for non-participating providers and execute on organizational strategies to ensure members are seeking care with participating providers when appropriate and initiating closing Network gaps as identified.
- Accountable for leading negotiations with Care Partners and other sophisticated entities. Prepares written status updates for key stakeholder reviews and aligns other network opportunities to ensure Market initiatives are met.
- Assess, manage, and develop network development team members to support achievement of network development goals.
- This position has supervisory responsibilities for members of the Network Development team.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- A Bachelor’s Degree in business, economics, healthcare administration, or a related field is required; extensive relevant experience will be considered in lieu of a degree.
- Five (5) or more years of professional experience required.
- Four (4) or more years of experience in network development, network management, or reimbursement model design required.
- Three (3) years prior management experience strongly required.
- Experience with successfully executing and implementing payer-provider contracts or partnerships required.
- Experience with developing, presenting and analyzing various types of financial analyses in order to make informed strategic decisions required.
- Desire and ability to move quickly between strategic leadership, tactical execution, and managing analytics
- Knowledge of managed care practices and procedures, specifically in contracting language and negotiations. Provider relations is preferred
- Ability to effectively engage providers, ranging from national providers to regional integrated delivery systems to local physician practices
- Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures
- Excellent prioritization skills with a proven ability to manage multiple projects in parallel to completion, for Commercial, Medicare and Medicaid lines of business including significant experience with Value Based Incentive Risk and/or Shared Savings network contracting models.
- Superb written and verbal communication skills with an ability to effectively collaborate with internal and external executive leadership
- 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 understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.