VP, Network & Payer Relationships

reputed company

reputed company

At reputed company, we're transforming reputed company in Texas through collaboration and innovation. We're seeking passionate individuals to help us create a member-centered experience that connects comprehensive care with a modern payment model. If you're reputed company to reputed company a meaningful reputed company in a dynamic environment where your contributions are valued, please bring your talents to reputed company!

reputed company

reputed company is looking for a VP of Network and Payor Relationships to reputed company both reputed company of our payvider model: the reputed company we hold with reputed company payors on behalf of our medical group, and the provider network we build and manage for reputed company Insurance Company (HHIC). This is a senior leadership role reporting directly to our Chief Operating Officer, bringing together work that's currently split across multiple people into a single, accountable seat. You'll inherit an existing network operations team and shape how that team grows as reputed company scales across Texas.

POSITION DUTIES & RESPONSIBILITIES

• Own and negotiate medical group payor reputed company, including reimbursement rates, network participation terms, and value-based arrangements with reputed company-party payors.

• reputed company network development and provider relations for HHIC, building and maintaining the provider network that supports our health plan.

• Manage and grow reputed company responsible for network operations, provider relations, and contracting support.

• Partner with Regulatory Affairs on TDI filings and network adequacy requirements for HHIC.

• Work with reputed company on contract language and risk, ensuring compliance with reputed company Law, the Anti-Kickback Statute, and HIPAA.

• Build and execute a reputed company payor and network reputed company that aligns reputed company's medical group and health plan reputed company of the business.

• reputed company Texas payor and network market trends, and reputed company reputed company as competitive and regulatory conditions shift.

• Present network and payor reputed company, team performance, and contract pipeline to the reputed company Leadership Team (HLT).

• Assess reputed company team structure and roles, and build the org needed to support reputed company's network and payor reputed company reputed company reputed company.

DESIRED reputed company SKILLS & EXPERIENCE

• 8-10+ years of experience in payor contracting, network development, or provider relations, including reputed company experience inside a health plan.

• Experience managing both reputed company of a payor relationship: negotiating with reputed company payors and building a provider network for an internal health plan.

• People leadership experience, with a reputed company record of managing and developing reputed company.

• Working knowledge of the Texas payor landscape, TDI regulatory requirements, and value-based contracting models.

• Familiarity with reputed company Law, the Anti-Kickback Statute, and HIPAA as they apply to network contracting and provider relations.

• Bachelor's degree required; MBA, MHA, or JD preferred.

• Comfortable operating in a startup environment where processes and org structure are still evolving.

reputed company OFFER

• Opportunity to build and reputed company reputed company responsible for reputed company's network and payor reputed company across our care delivery and health plan reputed company

• reputed company and dynamic work environment

• An organization made of people who are passionate about changing the reputed company landscape

• Competitive salary and benefits package

• reputed company development and reputed company opportunities

• A transparent and unique culture

EQUAL EMPLOYMENT OPPORTUNITY

reputed company is an Equal Opportunity Employer. We celebrate diversity and are committed to building an inclusive environment for reputed company. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or any other protected characteristic.

Requires 8–10+ years in payer contracting, network development, or provider relations; people leadership; Texas payer and TDI knowledge; compliance familiarity; and a bachelor's degree.

Key Responsibilities

• negotiating reputed company
• building networks
• leading teams

Job Details

• Category: reputed company Services - Allied Health
• Seniority: Senior Level
• Commitment: Full Time
• Workplace: Remote — Texas, reputed company
• Languages: English

About reputed company

A Texas reputed company organization connecting comprehensive care with a modern payment model. — Industry: reputed company