Network Director Job Description

Posted today

Network Director

ChenMed, LLC - Miami, FL

We're unique. You should be, too.

We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?

We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.

The Network Director is to be the business relationships partner to the Regional Medical Director, Hospital and Community Care Team (RMD, HCT), supporting the Office of Medical Affairs. This is accomplished by developing and maintaining trusting external relationships with physicians and external specialists, hospital and post-acute providers, and payers in pursuit of improving outcomes and medical cost. Relationship goals include maximizing understanding of the ChenMed care model, establishing well defined partnerships, and honing mutually beneficial contractual terms.

The Network Director will collaborate with the Office of Medical Affairs, to include RMD, HCT, National Specialty Directors, MED COE, and Regional Finance Director towards performance objectives, value benchmarks, and processes to optimize the care received outside the ChenMed's centers and ensuring continuity of care for patients with integrated in-center care. As a senior leader, this incumbent is accountable for total medical cost for the one to two regions overseen.
ESSENTIAL JOB DUTIES/RESPONSIBILITIES:

Has direct accountability for total medical cost and quality of care external to ChenMed within the region.
Partners with Finance, Regional/Center Dyads, Specialty Care and Hospital and Community Care Team (HCT), to build a comprehensive network strategy to support center level performance metrics.
Represents ChenMed and ChenMed's model adeptly to the healthcare community and lead the development of strong partnerships with payers, hospital executives, & specialists in the region.
- Maintain knowledge of specialty and hospital cost trends, market dynamics, cost drivers.
- Conduct contract negotiations with provider groups as needed to enhance availability, accessibility, quality and value of services.
- Work with various departments (operations, legal, and payor relations) to ensure contracts meet operating, financial and legal standards.
Partners with HCT, National Specialty Directors, MED COE and regional leaders on cost savings opportunities, and share solutions sets developed by internal national specialty directors.
In partnership with Finance leaders,
- Presents medical cost and specialty key performance trends and opportunities to centers, regional and divisional leaders.
- Reviews ongoing performance and in-depth analyses on the marketplace provider quality and cost performance, to identify best partners in the community.
Collaborates with national specialist directors to
- Builds, refines and manages a tiered network of external specialists and facilities to form a Coordinated Provider and Facility List based on quality, care coordination, cost, and coverage
- Develops and implements new approaches to support improved medical cost performance (e.g., psychiatric care and emergency paramedic home visit programs).
Participates in executive, divisional and regional leadership meetings, financial and strategic planning meetings, and recruiting meetings.
Performs other duties as assigned and modified at manager's discretion.

KNOWLEDGE, SKILLS AND ABILITIES:

Ability to interpret data trends & present opportunities to physicians, clinical & business leaders
Current, relevant, and substantial knowledge of areas related to medical cost, quality and value, and other clinical issues, especially within a managed care environment, required
Ability to establish and maintain positive and effective work relationships with coworkers, clients, and providers and to work effectively independently and as part of a team
Demonstrated success in persuasion, influence, and negotiation, excellent customer service skills
Demonstrated ability to provide leadership to PCPs and staff, and to build the trust and respect of leaders, colleagues, and external contacts
Understands and is committed to maintaining highest level of confidentiality
Knowledge of Medicaid/Medicare plans
Excellent management and reasoning abilities; ability to work in a fast-paced environment
Excellent presentation, verbal and written communication skills
Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software; analytical software packages such as Power BI, QlikView and Qlik Sense desirable
Ability and willingness to travel locally, regionally and nationwide up to 75% of the time
Spoken and written fluency in English
This job requires use and exercise of independent judgment

EDUCATION AND EXPERIENCE CRITERIA:

BA/BS degree in Healthcare Administration or a closely related field required; additional experience above the minimum may be considered in lieu of the required education on a year-for-year basis; Master's degree a plus
Minimum six (6) years' experience building and managing national provider networks
Experience in budgetary and operational profit/loss with cost containment in value-based care
Experience working with health plans, specialists, hospital providers, and post-acute providers, including skilled nursing facilities, home health, behavioral health, social service, and other agencies; contract negotiation and account/vendor management

We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.

ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.

Current Employee apply HERE

Current Contingent Worker please see job aid HERE to apply