AVP-Provider Network-Contracting

  • Req #: 53649
  • Samaritan Health Services
  • Corvallis, OR
  • SHS Health Plan Ops - Strategy
  • 1.0 (80 hrs/pp) - Day
  • Start / End Time: 0800 (8:00 am) - 1700 (5:00 pm)
  • Overtime Rule: Exempt
Apply Now Save Job Saved

  • JOB SUMMARY/PURPOSE
    • Provides leadership and direction to the Provider Contracting and Provider Network Management functions for Samaritan Health Plans. Leads and drives the development and execution of comprehensive provider strategies that support both health plan and integrated system objectives. Develops and maintains key strategic relationships and partnerships with regional providers to advance key business objectives. Ensures there is appropriate provider network breadth and stability to support product and enrollment objectives.
  • DEPARTMENT DESCRIPTION
    • Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
  • EXPERIENCE/EDUCATION/QUALIFICATIONS
    • Bachelor's degree or equivalent experience in a related field required.
    • Six (6) years experience in the health care industry required.
    • Four (4) years experience in provider contracting for a health plan or payor contracting for a delivery system required.
    • Three (3) years management experience required.
    • Experience in a wide variety of provider reimbursement methodologies such as RBRVS fee schedules, per diems, DRGs, budgeted care models such as capitation, and other forms of value-based reimbursement strongly preferred.
  • KNOWLEDGE/SKILLS/ABILITIES
    • Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
    • Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
    • Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
    • Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.
    • Strong customer service skills - Intentionally and consistently provides high quality service and successfully delivers on commitments.
  • PHYSICAL DEMANDS
    • Rarely
      (1 - 10% of the time)

      Occasionally
      (11 - 33% of the time)

      Frequently
      (34 - 66% of the time)

      Continually
      (67 – 100% of the time)

      LIFT (Floor to Waist: 0"-36") 0-20 Lbs
       

      LIFT (Knee to chest: 24"-54") 0 - 20 Lbs
       

      LIFT (Waist to Eye: up to 54") 0 - 20 Lbs

      CARRY 1-handed, 0 - 20 pounds

       

      CARRY 2-handed, 0 - 20 pounds
       

      KNEEL (on knees)
       

      BEND FORWARD at waist
       

      CLIMB - STAIRS

      STAND
       

      WALK - LEVEL SURFACE
       

      ROTATE TRUNK Standing
       

      REACH - Upward
       

      PUSH (0-20 pounds force)
       

      PULL (0-20 pounds force)

      SIT
       

      ROTATE TRUNK Sitting
       

      REACH - Forward
       

      MANUAL DEXTERITY Hands/wrists
       

      FINGER DEXTERITY
       

      PINCH Fingers
       

      GRASP Hand/Fist

      None specified

Share:

Not the right fit?

Join our Talent Network to opt-in to all our current and future opportunities!

Join our Talent Network