Director, Value Based Contracting & Network Development
Company: Cardinal Innovations Healthcare Solutions
Posted on: February 25, 2021
Director, Value Based Contracting & Network Development Job
Category: D - Director/Functional Leader The Director of Value
Based Contracting & Network Development will report to the Vice
President of Network Management and will oversee the contracting
activities. The position has direct reports, who collaboratively
produce work aimed at supporting and strengthening Cardinal
Innovation's mission. The Director of Development & Contracting
will lead all aspects of provider network strategy, overseeing the
development and execution of strategies that position Cardinal, its
leadership and business favorably. To do this, this position is
responsible for daily decision making, anticipating challenges and
future needs. The position must be able to understand Cardinal
Innovation's goals and desired outcomes in relation to the
contracting & network development functions. As such, the ideal
candidate for this role has proven experience leading
cross-functional initiatives, managing a multi-discipline work
force. Essential Functions
- Lead all aspects of provider network strategy and contracting
activities, including access analysis, network operations and
support decision makers with analysis related to reimbursement and
unit cost management.
- Oversee the coordination and negotiation for contracting,
safeguarding contract and credentialing compliance.
- Establish the department's strategic vision objectives and
policies & procedures.
- Develop and implement a departmental strategy focused on
production and quality standards for contracting in order to meet
- Oversee the network development staff in the development of
- Perform periodic analyses of the provider network from a cost,
coverage, and growth perspective.
- Negotiate competitive and complex, value-based contractual
relationships with providers according to pre-determined internal
guidelines and financial standards.
- Build relationships with value-based contracting groups and
their associated teams.
- Lead efforts and accept responsibility for the financial and
quality of performance of value-based contract.
- Collaborate with value-based contracting provider groups to
achieve the quality performance benchmarks established in the
- Lead change management to ensure a successful practice
performance under value-based contracts.
- Design, deploy, and provide ongoing monitoring that addresses
provider performance gaps for quality metrics and benchmarks
related to value-based care initiatives.
- Establish oversight, monitoring and management processes aimed
at optimizing results, including defining the underlying metrics of
value-based programs and alternative payments models.
- Expand value-based contracted provider network, exclusivity
arrangements and network opportunities, while maintaining
relationships with providers and external partners /
- Provide leadership in evaluating opportunities to expand,
enhance or change the alternative network payment model to meet
company goals and manage networks costs & provider contracts.
- Oversee analysis of claim trend data and/or market information
to derive conclusions to support contract negotiations.
- Conduct periodic review of alternative payment models and
value-based provider contracting rates to ensure strategic focus is
on target with overall company strategy.
- Oversee network development staff and external consultants in
the development of provider networks across counties.
- Partner with leadership to ensure process change needs are
identified and developed, and that related ongoing training is
- Provide training, ongoing mentoring and consultation to
department members, providers, and internal staff on Cardinal
Innovation's applicable policies and procedures.
- Assist Vice President of Network Management and/or COO with key
network development strategies. Knowledge, Skills and Abilities:
- Able to read and comprehend complex written materials as well
as spoken information.
- Able to establish and maintain effective working relationships
with internal and external customers, as well as ensure direct
reports are doing the same.
- Demonstrated skills and experience in collaborative, strategic
and analytical thinking.
- Proven experience uncovering obstacles and implementing an
innovative troubleshooting approach.
- Strong interpersonal skills and demonstrated ability to take
leadership simultaneous on multiple projects.
- Proven ability to manage large-scale projects in a fast-paced,
deadline-driven, and highly collaborative environment.
- Expected to work well in a technically complex
- Display willingness to make timely decisions; exhibits sound,
accurate and independent judgment.
- Ability to travel. Qualifications To perform this job
successfully, an individual must be able to perform each essential
duty satisfactorily. The requirements listed below are
representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with
disabilities to perform the essential functions. Education and Work
- Bachelor's Degree or equivalent work experience in Business
Administration, Healthcare Administration or related field.
Advanced degree ideal.
- Advanced proficiency with Healthcare, Managed Care
Organization, or Managed Behavioral Healthcare. Experience:
- 10+ years of experience in managed care network development and
provider relations/contracting management in a health care and/or
managed care environment.
- At least 5 years of experience managing a staff of direct
reports, including responsibilities for hiring, training, assigning
work and managing performance of staff.
- Proficient with MS Office suite (Word, Excel, PowerPoint).
- Entrepreneurial spirit with a demonstrated ability to work
collaboratively and influence others.
- Effectively communicate at all levels of the organization both
internal and external.
- Experience in strategic positioning, developing, executing and
adhering to business plans. Valid Driver's License Required: Yes
Travel Type: None Required Percentage: None Language: Read Write
Speak Spanish --- --- --- Other: --- --- --- Licensure and/or
Certification Equal Opportunity Employer/ Protected Veteran/
Individuals with Disabilities Cardinal Innovations is firmly
committed to the policy of providing equal employment opportunity
(EEO) to all of its employees and applicants for employment without
regard to race, age, color, sex, religion, creed, veteran status,
genetic information, national origin, non-job related disability,
sexual orientation, and/or gender identity or expression (except as
mandated by law). Employment at Cardinal is based solely on a
person's merit and qualifications directly related to professional
competence. For that reason, we consider qualified applicants
regardless of criminal histories, consistent with legal
requirements. Our equal employment opportunity philosophy complies
with federal, state and local law and applies to all aspects of
employment with Cardinal, including recruiting, hiring, training,
transfer/promotion, compensation, benefits and termination.-- If
you have a disability or special need that requires accommodation,
please let us know by contacting Cardinal's Human Resources
department at HumanResources@cardinalinnovations.org Someone from
the HR team will reach out to see how we may be able to assist.
Physical Demands/ Working Conditions Physical Demands N/A Rarely
Occasionally Frequently Constantly --- --- --- --- Balancing,
Lifting, Carrying, Pushing, Pulling
Keywords: Cardinal Innovations Healthcare Solutions, Charlotte , Director, Value Based Contracting & Network Development, Executive , Charlotte, North Carolina
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