Director (Contract And Network Development)


Boston, MA

What you'll be doing

Develops and maintains strategies, systems and processes required to ensure the delivery of cost-effective, quality health care services by network of contracted healthcare providers through establishment of fair rates and contract terms. Directs the development and implementation of short and long-term strategies to ensure that all members across all product lines have access to a comprehensive network of quality health care facilities, professionals and ancillary services providers. S/he works with key internal stakeholders to develop and maintain provider network adequacy standards. Directs contracting staff in negotiations and re-negotiations of provider agreements that will ensure appropriate alignment of medical expense and revenue. Assures that all provider networks across all product lines are in compliance with all network adequacy standards. Coordinates responses and reporting to identified external state agencies.

What your background should be

Must have 10+ years of related provider reimbursement/contract negotiations and financial analysis experience, including a minimum of 8 years prior supervisory experience. 10-15 years prior related experience in managed care is preferred. Should have detailed knowledge of contract compliance and contract processes especially in managed care environment.

Required Schooling / Training

Bachelor degree in finance, business administration or related field or the equivalent.

Who is the client company

This company is a not for profit managed care organization.
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