Job Description

Your Role

The Sr Director, Provider Contracting will report to the Vice President, Provider Network Management- South. In this role you will oversee Ancillary Contracting. This role will drive the development and implementation of affordability initiatives to achieve BSC profitability and savings goals related to Ancillary Network, clinical programs and portfolio analytics. This leader will amplify ancillary network management activity through expert contact negotiation and oversight of network providers to control costs and support high-quality care.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

• Develop comprehensive contracting strategy for ancillary services that drives CoHC savings. This may include developing strategic partnerships, targeted narrowing or expansion of the network for certain services and geographies, and payment structure changes.
• Lead ancillary network management activity for commodity services including lab, infusion, and durable medical equipment, and other ancillary services as assigned. This includes negotiating contracts, managing the network of providers, ensuring compliance, and monitoring performance to control costs and support high-quality care.
• Develop contracting strategy for Skilled Nursing Facilities to improve access and enable faster transition of members from inpatient acute to step-down care. Lead Skilled Nursing facility contracting team to negotiate and execute contracts, manage the provider network, and monitor provider performance.
• Ideate and evaluate innovative care delivery solutions in collaboration with Partner Services, Product and HQA leadership and vendors.
• Own ancillary network remediation activities- negotiating contracts, managing the network of providers, ensuring compliance, and monitoring performance to control costs and support high-quality care.
• Support broader network negotiations and other network management department objectives as needed
• Contribute to HQA AI strategy and make recommendations on area of potential implementation.
• Forecast ROI benefits
• Lead and mentor a team of healthcare professionals. Foster a culture of excellence and continuous improvement. Collaborate with affordability office, finance, clinical, and operational teams to ensure strategic alignment to attain BSC financial targets.

Your Knowledge and Experience

• Requires a Bachelor’s degree or equivalent experience
• MPH, MBA, or MHA is preferred
• Requires 12 years of provider contracting experience, preferably within a managed care organization with a focus on healthcare quality and affordability and health plan operations.
• Requires 8+ years of direct experience leading and managing staff.
• Proven track record of developing and implementing successful strategies that drive cost savings and improve healthcare value.
• Capacity to lead and inspire cross-functional teams to achieve high-performance results.
• Exceptional skills in both written and verbal communication and extensive executive communication experience
• Strong analytical skills and experience leveraging data to inform strategy and measure performance.
• Ability to address and resolve complex operational challenges effectively.
• Ability to navigate and adapt to a rapidly changing healthcare landscape.

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.