Director, Government Contracting Provider Affiliations

Job ID: J111176
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at:

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Description

JOB SUMMARY

This job is connects the product and marketing strategies of Government Markets to the product and provider network strategies and provider affiliations to maximize Government Market product growth and member retention.  The incumbent understands Government Markets' strategies and products and works internally and externally with providers to ensure alignment and execution to strategies.  The incumbent works primarily with Senior Markets and understand the strategies and products in order to develop, execute, and manage the tactics necessary to support Senior Markets strategy within the provider network.  Works collaboratively across the organization to connect strategies and tactics of Senior Markets to the provider network strategies and provider affiliations.
 

ESSENTIAL RESPONSIBILITIES

  • Perform management responsibilities including, but not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.  Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
  • Lead and facilitate Medicare Advantage marketing initiatives that impact the provider network and collaborate with the appropriate Product, Network and Reimbursement and other internal teams as appropriate to ensure connections to current work is aligned and execution of new activities occurs in a timely manner.  Lead and facilitate Medicare Advantage provider education initiatives including outreach and communication to key strategic partnership providers, primary care physicians, hospitals,  and specialists
  • Evaluate the success of strategies and tactics executed within the provider network as they relate to Government Markets, their unique products, and providers. Monitor, understand, and communicate the impact of regulatory changes on the execution of various products and networks.   Develop strategies to respond to those issues.  In partnership with cross functional parties, make modifications to mitigate negative impacts to members and product and network viability
  • Understand the Organization’s provider gain and risk share models and design government market modifications that  support future product viability and financial performance rewarding providers for superior performance in all aspects of the Medicare Advantage product relationship
  • Other duties as assigned.

EDUCATION

Required

  • Bachelor's Degree in Business Administration/Management or Health Administration

Substitutions

  • None

Preferred

  • Master's Degree in Business Administration/Management or Health Administration

EXPERIENCE

Required (one of the following)

  • 5 - 7 years in the Healthcare Industry
  • 3 - 5 years in the Health Insurance Industry

To include (one of the following)

  • 1 - 3 years in Medicare
  • 1 - 3 years in Medicaid

And

  • 3 - 5 years in Management

Preferred

  • None

LICENSES AND CERTIFICATIONS

Required

  • None

Preferred

  • None

SKILLS

Required (one or more of the following)

  • Healthcare Management
  • Influence and Persuasion
  • Strategic Planning
  • Oral & Written Communication Skills

Preferred

  • Member Services Systems

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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