VP, Network Development

Richmond VA 23233

Job Description

The VP, Network Development is responsible for developing and implementing a strategic plan that meets the customer requirements within budget plan and assures access to a network of services that supports member access and are within cost of care plans for Magellan Complete Care of Virginia. The position is responsible for delivering insight into product development and operational improvements.

Essential Functions

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  • Develops and implements a network to meet the needs of the SBU, clients and members. 
  • Ensures unit cost targets are met. 
  • Assures long term mutually successful provider relationships.
  • Directs all provider (free standing facility, hospital, and in-office) recruitment activities.
  • Assumes lead role in negotiations with key providers as required.
  • Hires, trains and provides supervision, development and mentoring of staff in meeting objectives and functions. 
  • Develops negotiation strategies to ensure results are within financial projections. 
  • Measures performance of individual team members, balances work loads and develops hiring plans to meet network development needs.
  • Provides guidance on fee schedule development, underwriting and unit cost trend management.
  • Manages financial goals (e.g., control care cost trends, profitability) as defined by the business operations and the SBU, including assuring that the network is cost effective, marketable, stable and offers appropriate access. 
  • Monitors ongoing provider performance changes in cost and utilization needs. 
  • Supports  strategy for new products/product enhancement with product development division. 
  • Develops and maintains positive relationships between Magellan and providers and influences and changes behavior of providers in accordance with business operations goals and objectives.
  • Prepares, analyzes, reviews and projects financial/systems impacts of various negotiation strategies. 
  • Develops and analyzes RFPs to support contracting initiatives.
  • Supports sales on RFPs and participates in sales presentations to prospective clients.

General Job Information

Title

VP, Network Development

Grade

32

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

12/2/2019

Date Requisition Created

12/2/2019

Work Experience

Network

Education

Bachelors (Required), Masters

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

Required Qualifications

  • 10+ years of experience in healthcare and/or business experience with direct provider credentialing, data entry and/or contracting experience, in a managed care environment preferred.
  • Minimum 8 years of previous management, project management, or leadership experience.
  • Proven ability to strategically lead an organization toward the attainment of its goals and objectives, mission and values.
  • Demonstrated negotiation and influencing skills.
  • Excellent communication skills.
  • Advanced Microsoft Office Suite knowledge, specifically Excel.
  • Demonstrated team building skills to promote an environment of diversity, collaboration and recognition.
  • Management/leadership skills, ability to successfully analyze and resolve complex problems, ability to motivate and train others, organizational skills, problem-solving, knowledge of quality improvement processes, demonstrated attention to detail and accuracy, communication skills and the ability to establish team relationships.
  • Skills in planning, tracking and auditing performance data.
  • Demonstrated financial analysis and decision making skills.

Preferred Qualifications

  • Understanding of health delivery systems.
  • Knowledge of managed health care, health care trends, including reimbursement and coding and network management/administration.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.