VP Provider Relations # 10437 - (US-TN-Nashville - 37250)

Compensation: $100K - $100K / Year
Minimum Education: Bachelors
Job Type: Full Time
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JOB SUMMARY:
Lead all aspects of Provider Network Management to include provider network strategy, provider contracting, provider relations and operations to support provider service, network development, provider education, and product and market expansions. Responsibilities include the strategic analysis and negotiations for network management, including organizational management, complex contracting, and contracting efforts to support MEIs. Provider Network Management includes all aspects of interaction with claim centers, Business Solutions, HCMS, QI and Service Center Operations. The Provider Relations VP may also work closely with our client or regulatory partners to achieve high level of compliance and customer satisfaction. It is further expected this leadership position is a key part of the health plan leadership team supporting important operational and leadership aspects of the health plan.
PRIMARY RESPONSIBILITIES:
1.Responsible for managing and improving network management operations to achieve or exceed performance standards/budgets.
2.Leads the development of provider network business plans, strategies and goals.
3.Responsible for hiring, developing, training and retaining high-quality, productive employees.
4.Develops and manages provider contracting efforts and partnerships to achieve quality, cost management, and strategic business development objectives.
5.Assists the CEO/COO with aspects of local and state government relationships, including dealing with regulators as necessary to establish and continue effective working relationships.
6.Effectively represent AGP in interaction and negotiation with the provider network.

EDUCATION AND EXPERIENCE:
Education
Required: College degree required.
Preferred: Advanced degree preferred
Years and Type of Experience
Required: Minimum ten (10) years experience in managed care, with minimum eight (8) years in managed care administration, and two (2) years in executive management.
Preferred:
Specific Technical Skills
Required:
*Demonstrated experience with team management and performance improvement.
*Strong understanding of the healthcare industry, managed care and health plan operations
Preferred:
*Experience leading a company or division with a distinct P and L is considered a positive.
*Experience with government programs preferred.
*Knowledge of Medicaid reimbursement methodologies is desired.
*Experience in large, complex negotiations and contracting efforts.
*Documented success in operational management.
*Ability to successfully interact with senior executives of the AGP organization as well as community Healthcare clinical professionals and business executives nationwide.

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