VP, Provider Strategy

United States

Job Description

As a primary focus, this role execute on our strategy for improving the overall value of the provider networks for our customers and participating providers.
  • Develops contract templates which support market changes.
  • Implements strategies for optimizing the cost of care through innovative reimbursement strategies and value based arrangements.
  • Develops and modifies provider development tools as needed to achieve success with providers serving commercial, Medicare, Medicaid and Dual-eligible members; Create a “unified” and consistent approach, including strategies which increase shared reward opportunities.
  • Represents Magellan as a progressive thought leader in the industry, with a focus on improving the provider and consumer experience.
  • Drives and supports initiatives to position Magellan as a leader in helping people achieve lifelong well-being and align this objective with business strategies supporting Provider Development & Value Base goals.
  • Develops and communicates specific market growth strategies to Provider Development and National Contracting, including opportunities for Magellan to insure greater financial success for providers via medical cost containment strategies and refined value base and risk contracting relationships.

General Job Information

Title

VP, Provider Strategy

Grade

32

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

1/29/2019

Date Requisition Created

1/29/2019

Minimum Qualifications

Education

Bachelors (Required)

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • Prior operational leadership experience within both managed care and provider environments, with comprehensive knowledge of health plan finance and the reimbursement arrangements between health plans and providers
  • Current perspective regarding payment reform initiatives and their impact on payer/provider business models is required, as it the ability to effectively articulate a strategy or value proposition to professionals across the continuum of health care business entities
  • Strong track record of building provider relationships and expanding business opportunities within a regional geography
  • Medicaid, Medicare and Commercial behavioral health managed care experience is essential
  • Experience building and managing relationships with a wide variety of providers
  • Minimum of 10 years’ experience developing forward thinking provider agreements
  • Bachelor's degree in related field

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled