Source Job

• Help network development and contracting goals within designated geographies.
• Develop and refine local contracting strategies to drive provider participation in Medicare Advantage, Direct Contracting and other value-based initiatives.
• Address and resolve any concerns raised by providers and effectively communicate those solutions to internal stakeholders.

Clover Health is a Medicare Advantage and Prescription Drug plan changing how healthcare is delivered by combining data with human empathy to keep members healthier. They are passionate and mission-driven individuals, working together to solve the most complicated problem in the world: healthcare.

• Negotiate MA & Medicaid value-based care contracts with prospective payer partners.
• Collaborate with Senior Leadership to qualify and source market growth and expansion for multi-year risk arrangements.
• Build and manage relationships with payers and other key stakeholders to resolve issues and optimize performance.

Aledade empowers independent primary care practices to deliver better care to their patients and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country, operating with a collaborative, inclusive, and remote-first culture.

• Serve as the primary contact for CM/UM programs and operational questions related to the MyCare Platform.
• Build relationships with provider offices through outreach and timely follow-up, resolving issues within defined turnaround times.
• Educate providers on submission requirements, documentation, timelines, and available CM/UM resources.

Personify Health created a personalized health platform, bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together. They serve employers, health plans, and health systems with data-driven solutions that reduce costs while improving health outcomes.

• Enrolls providers new to Privia with all commercial health plans specific to the market.
• Updates and maintains provider enrollment status in credentialing system, CredentialStream.
• Performs follow up with health plans according to designated timeline, until Provider is PAR.

Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices. Privia Health consists of scalable cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

• Manage complex provider roster creation, submission, and record reconciliation for multiple payers.
• Oversee resolution of moderate-scope issues by prioritizing tasks and escalating issues with solutions.
• Proactively identify areas for operational improvement and efficiency enhancement.

Aledade empowers independent primary care practices to deliver better patient care and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.

• Oversee the Commercial segment within the Strategic Payer Partnerships team ensuring performance goals and objectives are met.
• Collaborate with Executive Leadership to shape Aledade's strategy for value-based contracting on behalf of independent primary care practices.
• Lead, direct, and evaluate a team of senior leaders ranging from Manager to Sr. Director.

Aledade empowers independent primary care practices to deliver better care to their patients and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.

• Own & Manage Provider Relationships : Serve as the primary point of contact for provider primary care partners.
• Support Provider Recruitment Activities as Product SME : Partner with CA GTM team to execute a provider onboarding and training best practices.
• Optimize Provider Success & Retention : Implement and oversee a structured engagement plan to ensure providers maximize their use of our platform.

Counterpart Health is transforming healthcare with its AI-enabled primary care tool, Counterpart Assistant, that supports early diagnosis and management of chronic conditions. They drive value-based care at the speed of software with a team of value-based care and technology experts.

• Lead and manage a team of Regional Directors, providing coaching and performance feedback.
• Oversee the delivery of consulting services to specialty provider practices.
• Develop and implement strategies to support the needs of specialty customers.

The company is looking for a Lead Director, Managed Care. They value creating an inclusive culture by empowering employees to bring their unique and diverse selves to work.

• Help develop and execute the provider growth playbook.
• Generate leads, contact therapists and drive therapist contracting.
• Partner with onboarding teams and other operations teams to translate sales insights into business improvements.

BetterHelp's mission is to remove the traditional barriers to therapy and make mental health care more accessible. Founded in 2013, they are the world’s largest online therapy service, providing affordable and convenient therapy across the globe.