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Job Summary
This position is responsible for directing all negotiations, strategies and direct execution of the business plan for providers in our HealthSpring Alabama (includes MS and Northwest FL) and Georgia markets. There will be emphasis on key health systems and providers that contribute $10M or more in annual allowed spend, though this Leader and their team will be responsible for contracting all medical agreements across these markets. The role is responsible for market and partner direct relationship development, critical contract negotiations, establishing fee-for-service and value based contracts that enable financial and operational engagement strategies and internal cross-functional engagement with matrix partners. Role also will include leading and/or supporting select additional strategic plan initiatives that involve high value partners, inclusive of cross-functional strategic projects within Healthcare Delivery and network and value-based care program evolution, where high value provider partners are targeted for participation. Leader must work collaboratively with key network finance, contracting, analytics and operations areas as well as with enterprise areas to ensure there is alignment with partner strategies and the financial implications thereof; documenting and conducting analysis of current and proposed contract arrangements and its impact on HealthSpring strategy and managing its impacts on divisional and departmental short term and long term planning.
Required Job Qualifications:
- Bachelor degree and 7 years experience in health care, health insurance, or strategic consulting environment
- 2-4 years management experience with an emphasis on experience managing external stakeholders
- Experience with strategic planning, financial and data analysis, and research
- Working knowledge of various health insurance products.
- Strong financial acumen including understanding of financial statements and network contribution to plan financial performance.
- Experience leading and mentoring staff.
- Contract negotiation, development and execution.
- Clear and concise verbal and written communication skills.
- Experience with interacting successfully with senior management and staff across multiple departments.
- Organizational skills, including ability to prioritize tasks.
- Creativity in problem solving and create processes within ambiguity.
- Business acumen and project/process integration skills.
Preferred Job Qualifications:
- MBA or MHA.
- Health care industry experience.
- Medicare Advantage knowledge and expertise.
- Commercial, Affordable Care Act knowledge and/or Medicaid MCO.
- Knowledge a plus.
This is a Flex (Hybrid) role: 3 days in office; 2 days remote.
Sponsorship is not available.
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Pay Transparency Statement:
At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range
$100,000.00 - $180,700.00
Exact compensation may vary based on skills, experience, and location.